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Experience with TEM in Germany

R Salm1, H Lampe, A Bustos

  • 1Dept. of General Surgery, University Hospital, Freiburg, Germany.

Endoscopic Surgery and Allied Technologies
|October 1, 1994
PubMed
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Transanal endoscopic microsurgery (TEM) is a minimally invasive rectal surgery for adenomas and early carcinomas. This study found TEM safe and effective, with a low complication and mortality rate, especially when performed by experienced surgeons.

Area of Science:

  • Colorectal Surgery
  • Minimally Invasive Procedures
  • Surgical Oncology

Background:

  • Transanal endoscopic microsurgery (TEM) is a key technique for local rectal lesion removal.
  • Its adoption and outcomes in Germany warrant detailed investigation.

Purpose of the Study:

  • To evaluate the experience and outcomes of Transanal endoscopic microsurgery (TEM) in German surgical departments.
  • To assess the safety, efficacy, and complication rates of TEM for rectal adenomas and early carcinomas.

Main Methods:

  • A nationwide survey of 57 surgical departments performing TEM.
  • Evaluation of 44 returned questionnaires detailing 1,900 recorded TEM operations.
  • Analysis of indications, conversion rates, secondary procedures, complications, and mortality.

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Main Results:

  • Indications included 1,411 adenomas, 433 carcinomas, and 56 other procedures.
  • Conversion to laparotomy ranged from 1.2% to 11.6%, influenced by surgeon experience.
  • Complications occurred in 6.3% of patients, with a 0.2% mortality rate.

Conclusions:

  • Transanal endoscopic microsurgery (TEM) is a safe and effective minimally invasive option for rectal adenomas and early carcinomas.
  • Surgeon experience significantly impacts the conversion rate to laparotomy.
  • TEM offers a low complication and mortality profile, supporting its continued use in selected rectal pathologies.