[Transanal endoscopic microsurgery for local excision of rectal neoplasms]

We removed 30 benign, sessile, rectal polyps by the transanal approach between January 1990 and April 1994. In 16 patients we used transanal endoscopic microsurgery (TEM), while in 14 the adenoma was removed by submucosal excision (SE). There were 3 local recurrences in the SE group, but none as yet in the TEM group. There was no operative mortality. Early complications included myocardial infarction in 1 patient and persistent postoperative fever which responded to antibiotic treatment in another. Late complications included temporary, anal mucous leakage in 10% and 5% of the TEM and SE groups, respectively. TEM was found to be efficient for the removal of polyps in the upper and middle thirds of the rectum, and SE for those in the lower third. This enables safe removal of rectal polyps, avoiding the need for complex operations involving greater risks.