title: Transanal endoscopic microsurgery: a single surgeon's experience.
abstract: OBJECTIVE
  To evaluate a single surgeon's experience with transanal endoscopic microsurgery (TEM) with regard to incidence of complications, recurrence rate of benign and malignant lesions, and impact on the treatment of rectal cancer.
  
  
  METHODS
  Prospective tumor registry.
  
  
  METHODS
  Tertiary care university hospital.
  
  
  METHODS
  Seventy-three patients undergoing TEM between January 1991 and November 1996.
  
  
  METHODS
  Complications, recurrence rates, and use of this technique with respect to radical operations.
  
  
  RESULTS
  The arrival of TEM was associated with an increase in the number of operations for rectal cancer; however, the use of TEM remained constant relative to radical resections. Use of TEM resection alone is appropriate for all adenomas and cancers staged Tis and T1. Use of TEM alone is not an appropriate treatment for T2 cancers. Four patients (5%) experienced fecal soilage, which was long lasting in only 1 (1%).
  
  
  CONCLUSIONS
  Transanal endoscopic microsurgery is a safe technique and provides improved access to lesions in the middle and upper rectum. Thus far, it has not had a significant impact in the overall treatment of rectal cancer.
authors.affiliation: Department of General Surgery, Rush-Presbyterian-St Luke's Medical Center, Chicago, Ill 60612, USA.
authors.forename: T J
authors.initials: TJ
authors.lastname: Saclarides
mesh_terms: D000236:Adenoma / Q000601:surgery*; D001003:Anal Canal; D004724:Endoscopy / Q000009:adverse effects / Q000379:methods*; D006801:Humans; D015994:Incidence; D008866:Microsurgery / Q000009:adverse effects / Q000379:methods*; D011183:Postoperative Complications; D011446:Prospective Studies; D012002:Rectal Diseases / Q000601:surgery*; D012004:Rectal Neoplasms / Q000601:surgery*; D012042:Registries; D016896:Treatment Outcome