Is transanal endoscopic microsurgery (TEM) a valid treatment for rectal tumors?
BACKGROUND
In 1983 G. Buess, in Germany, developed transanal endoscopic microsurgery (TEM), a new minimally invasive technique for the treatment of rectal tumors.


METHODS
Rectal lesions are excised through a modified rectoscope of 40 mm in diameter under stereoscopic control in the gas-dilated rectal cavity. Full-thickness excision, partial-wall excision, or mucosectomy can be performed. Seventy-one patients were treated with the TEM technique in our department. Major complications were observed in one patient (1.4%). No mortality was reported.


RESULTS
Histological examination revealed 40 (56.3%) villous adenomas, 6 (8.4%) pT1; 17 (23.9%) pT2; 5 (7%) pT3 carcinomas; and 3 ((4.2%) other lesions. The recurrence rate was 2.8% for adenomas and 2.8% for carcinomas. The overall survival at mean follow-up of 17 months was 96.4%.


CONCLUSIONS
The advantages of TEM are less or no postoperative pain, unrestricted mobility, short hospitalization, quick rehabilitation, and absence of skin scars.
Lezoche
E
E
Cattedra di Chirurgia Generale I, Istituto di Scienze Chirurgiche, Universita di Ancona, Ancona, Italy.
Guerrieri
M
M
Paganini
A
A
Feliciotti
F
F
Di Pietrantonj
F
F
D018253:Adenoma, Villous / Q000473:pathology / Q000601:surgery; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002277:Carcinoma / Q000473:pathology / Q000601:surgery; D019723:Endoscopes; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007413:Intestinal Mucosa / Q000473:pathology / Q000601:surgery; D007417:Intestinal Polyps / Q000473:pathology / Q000601:surgery; D008297:Male; D008866:Microsurgery / Q000295:instrumentation*; D008875:Middle Aged; D019060:Minimally Invasive Surgical Procedures / Q000295:instrumentation; D009364:Neoplasm Recurrence, Local / Q000473:pathology / Q000601:surgery; D009367:Neoplasm Staging; D011183:Postoperative Complications / Q000209:etiology; D020700:Proctoscopes; D012004:Rectal Neoplasms / Q000473:pathology / Q000601:surgery*