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Transanal endoscopic microsurgery for advanced polyps and early cancers in the rectum-Long-term outcome: A STROBE

Issam Al-Najami1, Carl Philip Rancinger, Morten Kobaek Larsen

  • 1Department of Clinical Research, University of Southern Denmark, Odense Department of Surgery, Odense University Hospital, Svendborg Department of Surgery, Aarhus University Hospital, Aarhus, Denmark.

Medicine
|September 8, 2016
PubMed

Insights

Transanal endoscopic microsurgery (TEM) is safe for rectal tumors. While malignant tumors had higher complication rates, TEM showed similar low recurrence rates for both benign and malignant rectal lesions.

Area of Science:

  • Colorectal Surgery
  • Minimally Invasive Procedures
  • Oncology

Background:

  • Transanal endoscopic microsurgery (TEM) is a key technique for rectal lesion resection.
  • The comparative outcomes of TEM for benign versus malignant rectal tumors, particularly regarding complications and recurrence, require detailed analysis.

Purpose of the Study:

  • To evaluate the outcomes of TEM procedures for rectal adenomas and early-stage cancers.
  • To compare complication and local recurrence rates between benign and malignant tumors treated with TEM.

Main Methods:

  • A prospective cohort study included 280 patients undergoing TEM between January 2008 and September 2015.
  • Outcomes, including mortality, recurrence, and complications, were systematically recorded and analyzed for both benign and malignant tumor groups.

Main Results:

  • Of 280 tumors, 176 were benign and 104 malignant. Malignant tumors exhibited significantly higher complication rates (24.0%) compared to benign tumors (10.8%) (P = 0.003).
  • Perforation into the peritoneal cavity was also significantly more frequent in the malignant group (P = 0.034).
  • Recurrence rates were similar: 8.3% for benign and 9.0% for malignant tumors. Thirty-day mortality rates were low in both groups (1.1% benign, 1.9% malignant).

Conclusions:

  • TEM is a safe and effective procedure for resecting both benign and malignant rectal lesions.
  • The technique demonstrates low mortality and complication rates, with comparable recurrence rates for malignant rectal tumors.

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