title: Role of transanal endoscopic microsurgery in the palliative treatment of rectal cancer.
abstract: BACKGROUND
  Palliative, minimal invasive treatment of rectal cancer is advocated in patients with advanced and incurable disease or poor clinical condition and in those who refuse radical surgery. Several methods have been used during recent years. We report our experience with palliative transanal endoscopic microsurgery.
  
  
  METHODS
  Between 1983 and 1995, 29 patients underwent transanal endoscopic microsurgery for palliation. Eleven patients had advanced malignant disease, nine were in poor clinical condition, and nine repeatedly refused radical surgery.
  
  
  RESULTS
  Intraoperatively one severe complication, an intra-abdominal perforation, occurred. The morbidity rate was 14%. Postoperatively, clinical signs were abolished or improved in all cases. Only three patients required further palliative resections after initial symptom relief.
  
  
  CONCLUSIONS
  Transanal endoscopic microsurgery is a successful approach in the palliative treatment of rectal cancer. The technique enables complete resection of rectal tumors. Although anesthesia is needed, the morbidity is low, even in patients with poor clinical condition.
authors.affiliation: Dept. of Surgery, University of Cologne, Germany.
authors.forename: A
authors.initials: A
authors.lastname: Türler
authors.forename: H
authors.initials: H
authors.lastname: Schäfer
authors.forename: H
authors.initials: H
authors.lastname: Pichlmaier
mesh_terms: D015746:Abdominal Pain / Q000209:etiology / Q000601:surgery; D000368:Aged; D000369:Aged, 80 and over; D003248:Constipation / Q000209:etiology / Q000601:surgery; D004724:Endoscopy / Q000009:adverse effects / Q000379:methods*; D005260:Female; D006471:Gastrointestinal Hemorrhage / Q000209:etiology / Q000601:surgery; D006801:Humans; D007415:Intestinal Obstruction / Q000209:etiology / Q000601:surgery; D008297:Male; D008866:Microsurgery / Q000009:adverse effects / Q000379:methods*; D008875:Middle Aged; D009367:Neoplasm Staging; D010166:Palliative Care / Q000379:methods*; D012002:Rectal Diseases / Q000209:etiology / Q000601:surgery; D012004:Rectal Neoplasms / Q000150:complications* / Q000473:pathology / Q000601:surgery*