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Review: transanal endoscopic microsurgery (TEM)

G Buess1

  • 1Abteilung für Allgemeinchirurgie, Eberhard-Karls-Universität, Tübingen, Germany.

Journal of the Royal College of Surgeons of Edinburgh
|August 1, 1993
PubMed
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Transanal endoscopic microsurgery (TEM) offers precise rectal surgery up to 20 cm. This minimally invasive technique shows low complication and recurrence rates for adenomas and early cancers.

Area of Science:

  • Colorectal Surgery
  • Minimally Invasive Procedures
  • Surgical Oncology

Background:

  • Transanal endoscopic microsurgery (TEM) is a specialized technique for rectal procedures.
  • It utilizes advanced equipment for dissection and suturing within the rectal cavity.
  • Optimal visualization is achieved through gas insufflation and stereoscopic vision.

Purpose of the Study:

  • To evaluate the efficacy and outcomes of Transanal Endoscopic Microsurgery (TEM).
  • To assess complication and recurrence rates for adenomas and early-stage rectal cancers treated with TEM.

Main Methods:

  • TEM involves full-thickness excision for sessile adenomas and carcinomas in the extraperitoneal rectum.
  • Procedures are conducted using a complex operative system with magnified stereoscopic vision.

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  • Patient outcomes regarding pain, complications, and recurrence were monitored postoperatively.

    • Main Results:

    • Postoperative recovery is painless for excisions distant from the dentate line.
    • TEM demonstrates a low complication rate compared to alternative surgical methods.
    • Recurrence rate for sessile adenomas was 3.5%, lower than conventional surgery.
    • One recurrence was observed in 29 patients with PT1 low-risk cancer.

    Conclusions:

    • Transanal endoscopic microsurgery (TEM) is a safe and effective procedure for rectal lesions.
    • The technique facilitates precise dissection, leading to reduced recurrence rates.
    • TEM offers a favorable alternative to conventional surgery for select rectal adenomas and early cancers.