title: Experience with TEM in Germany.
abstract: Transanal endoscopic microsurgery (TEM) presents a minimally invasive procedure for local removal of large adenomas as well as early carcinomas of the rectum. 57 surgical departments/clinics, which practice this method in Germany were asked about their experience. 44 questionnaires were evaluated. Indications for the 1,900 recorded operations were 1,411 adenomas, 433 carcinomas (curative intention: 286; palliative intention: 147), and 56 other procedures. The conversion rate to laparotomy was dependent on the experience with this surgical method (1.2%-11.6%). A radical rectal resection as a second step was performed in 5.7% of patients in the case of advanced carcinoma in the histologic examination of the specimen. Complications appeared in 120 patients (6.3%), 77 patients (4.0%) recovered with conservative treatment, and 43 (2.3%) had to undergo surgery. The mortality rate was 0.2% (3/1,900 pts).
authors.affiliation: Dept. of General Surgery, University Hospital, Freiburg, Germany.
authors.forename: R
authors.initials: R
authors.lastname: Salm
authors.forename: H
authors.initials: H
authors.lastname: Lampe
authors.forename: A
authors.initials: A
authors.lastname: Bustos
authors.forename: U
authors.initials: U
authors.lastname: Matern
mesh_terms: D001003:Anal Canal; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D005858:Germany; D006801:Humans; D008853:Microscopy / Q000295:instrumentation / Q000379:methods*; D009367:Neoplasm Staging; D011183:Postoperative Complications / Q000401:mortality; D011292:Premedication; D011300:Preoperative Care; D011351:Proctoscopy; D012004:Rectal Neoplasms / Q000000981:diagnostic imaging / Q000188:drug therapy / Q000401:mortality / Q000473:pathology / Q000601:surgery*; D012189:Retrospective Studies; D013503:Surgery Department, Hospital / Q000706:statistics & numerical data*; D015996:Survival Rate; D013997:Time Factors; D016896:Treatment Outcome; D014463:Ultrasonography
chemical_list: D000900:Anti-Bacterial Agents