title: Is transanal endoscopic microsurgery (TEM) a valid treatment for rectal tumors?
abstract: 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.
authors.affiliation: Cattedra di Chirurgia Generale I, Istituto di Scienze Chirurgiche, Universita di Ancona, Ancona, Italy.
authors.forename: E
authors.initials: E
authors.lastname: Lezoche
authors.forename: M
authors.initials: M
authors.lastname: Guerrieri
authors.forename: A
authors.initials: A
authors.lastname: Paganini
authors.forename: F
authors.initials: F
authors.lastname: Feliciotti
authors.forename: F
authors.initials: F
authors.lastname: Di Pietrantonj
mesh_terms: 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*