[Microsurgery in prospective comparison with conventional transanal excision or anterior rectum resection in adenomas...

In a prospective randomized study, transanal microsurgery (TEM) was compared with anterior resection (AR) for T1-carcinomas (n = 25 vs. 28) and with local submucosal excision for adenomas (n = 90 vs. 98). The TEM procedure was superior to AR in blood loss, operation time, analgetic demand, hospitalisation in carcinoma resection and for local relapse in adenoma resection (6% vs. 22%). The 5-year survival probability between TEM and AR was 96% for both techniques, thus advocating TEM as a considerable procedure for cure of T1-rectal carcinomas.