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[Early Rectal Cancer: Can Transanal Endoscopic Microsurgery (TEM) Become the Standard Treatment?]
Vestnik Rossiiskoi Akademii Meditsinskikh Nauk
|January 4, 2018
Summary
Transanal endoscopic microsurgery (TEM) offers effective treatment for rectal adenomas and selected cancers. This technique demonstrates low complication and recurrence rates in patient studies.
Area of Science:
- Colorectal Surgery
- Minimally Invasive Surgery
- Gastroenterology
Background:
- Transanal endoscopic microsurgery (TEM) is a key surgical approach for rectal adenomas.
- TEM is also utilized for specific types of malignant rectal tumors.
Purpose of the Study:
- To present the clinical experience and outcomes of Transanal endoscopic microsurgery (TEM).
- To evaluate the efficacy and safety of TEM in treating rectal adenomas and selected adenocarcinomas.
Main Methods:
- A cohort of 330 patients with rectal adenomas or selected adenocarcinomas underwent TEM.
- Preoperative assessment included digital rectal examination, rectoscopy with biopsy, colonoscopy, endoscopic ultrasound (EUS), and pelvic MRI.
- Surgical outcomes, including operating time, margin status, morbidity, and recurrence rates, were analyzed.
Main Results:
- Of 330 patients, 79.7% had adenomas and 20.3% had adenocarcinomas.
- Complete tumor removal with clear margins was achieved in all cases.
- The overall morbidity rate was 5.7%, with local recurrence rates of 2.0% for adenomas and 5.2% for adenocarcinomas during a median follow-up of 24 months.
Conclusions:
- Transanal endoscopic microsurgery (TEM) is a safe and effective procedure for rectal adenomas.
- TEM is associated with low morbidity and recurrence rates for selected malignant rectal tumors.
- The findings support TEM as a valuable treatment option in colorectal surgery.
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