Prospective study of the functional results of transanal endoscopic microsurgery.
OBJECTIVE
Most clinical research addresses the technological advances and oncological outcomes of transanal endoscopic microsurgery. Our aim was to examine the functional results.


METHODS
From August 1999 to November 2000, 22 Taiwanese patients (14 men, 8 women; median age, 68 years) undergoing transanal endoscopic microsurgery were prospectively examined. Functional questionnaires and anorectal manometry were assessed before surgery and at 2 weeks, 6 weeks, 3 months, and 1 year.


RESULTS
The median distance from the anal verge to the tumor was 10 cm. The median tumor diameter was 2.0 cm. The median duration of surgery was 120 minutes. No surgical mortality or morbidity and no local recurrence occurred during a median follow-up of 23 months. The mean stool frequency and consistency were significantly better at 3 months after surgery than before surgery. The maximal resting pressure significantly decreased after surgery. The maximal contraction pressure and maximal tolerated volume were significantly lower at 2 and 6 weeks than before surgery; these values recovered at 1 year.


CONCLUSIONS
Transanal endoscopic microsurgery is safe for the cure of benign tumors and the palliative excision of malignant tumors in middle and upper rectum. Anorectal function was preserved and improved, though some anorectal manometric parameters changed over time.
Division of Colon and Rectal Surgery, Department of Surgery, Veterans General Hospital-Taipei, National Yang-Ming University School of Medicine, Taipei, Taiwan, R.O.C. hswang@vghtpe.gov.tw
Huann-Sheng
HS
Wang
Jen-Kou
JK
Lin
Shung-Haur
SH
Yang
Jeng-Kae
JK
Jiang
Wei-Shong
WS
Chen
Tzu-Chen
TC
Lin
D000230:Adenocarcinoma / Q000601:surgery; D018253:Adenoma, Villous / Q000601:surgery*; D000368:Aged; D000369:Aged, 80 and over; D013505:Digestive System Surgical Procedures; D016145:Endoscopy, Digestive System; D005260:Female; D006801:Humans; D008297:Male; D008365:Manometry; D008866:Microsurgery / Q000379:methods; D008875:Middle Aged; D011446:Prospective Studies; D012004:Rectal Neoplasms / Q000601:surgery*