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Related Experiment Videos

Transanal endoscopic microsurgery in Italy

M M Lirici1, L Chiavellati, E Lezoche

  • 14th Department of General Surgery, University of Rome, La Sapienza, Italy.

Endoscopic Surgery and Allied Technologies
|October 1, 1994
PubMed
Summary

Transanal Endoscopic Microsurgery (TEM) in Italy involved 122 patients. TEM showed promise for rectal tumors, with no mortality and low recurrence rates, especially when combined with adjuvant therapies.

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Area of Science:

  • Gastroenterology
  • Surgical Oncology
  • Colorectal Surgery

Background:

  • Transanal Endoscopic Microsurgery (TEM) has been utilized in Italy since 1991.
  • Early Italian experience involved 122 patients undergoing TEM by April 1994.
  • Protocols varied, particularly for rectal cancer indications and adjuvant therapies.

Purpose of the Study:

  • To report the initial Italian experience with Transanal Endoscopic Microsurgery (TEM).
  • To evaluate the outcomes of TEM for benign and malignant rectal lesions.
  • To assess the feasibility and preliminary results of TEM for advanced rectal tumors.

Main Methods:

  • Surgical procedures were performed across six Italian centers.
  • Standard TEM protocols were used for benign lesions.

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  • TEM indications were extended to more advanced rectal cancers, with some receiving adjuvant radiation or chemoradiation.

    • Main Results:

    • Postoperative morbidity was 15.8% for adenomas and 29.6% for carcinomas.
    • No postoperative mortality was observed.
    • Local recurrence rates were 10.5% for adenomas and 9.25% for carcinomas, with no recurrences reported for TEM combined with adjuvant therapy.

    Conclusions:

    • Transanal Endoscopic Microsurgery (TEM) is a viable technique for rectal tumors in the Italian experience.
    • The combination of TEM with adjuvant radiation treatments appears to reduce local recurrence rates for rectal cancer.
    • A randomized trial is planned to further evaluate TEM for locally advanced rectal cancer.