title: [Transanal endoscopic microsurgery for tumours in rectum].
abstract: BACKGROUND
  Rectal tumors up to 25 cm from the anal verge may be resected by transanal endoscopic microsurgery (TEM). TEM is suitable for resection of benign adenomas, but can also be used for selected malignant tumours.
  
  
  METHODS
  Based on review of the literature and our own experience with 150 procedures, we present a review of the method and indications for TEM.
  
  
  RESULTS
  TEM is a safe and suitable method for resection of rectal adenomas that cannot be radically removed by endoscopic methods. TEM offers lower recurrence rates and less morbidity than traditional treatment. Large tumours and involvement of the microscopical resection margin disposes for recurrence. Selected malignant tumours (like small carcinoid tumours and early stage [Tis, T1] adencarcinomas) with higer moderate differentiation may be resected by TEM with the same oncological result as open surgery.
  
  
  CONCLUSIONS
  Tumours can be resected in the entire rectum with TEM. TEM is especially suitable to resect benign adenomas, and may also have a place as primary treatment of selected malignant tumours in Norway. Depending on selection criteria and combination with radiotherapy, the method may be suitable for 30 - 110 patients/year with rectal cancer in Norway.
authors.affiliation: Kirurgisk avdeling, Akershus universitetssykehus, 1478 Lørenskog. ola.rokke@ahus.no
authors.forename: Ola
authors.initials: O
authors.lastname: Røkke
authors.forename: Arne E
authors.initials: AE
authors.lastname: Faerden
authors.forename: Kjell
authors.initials: K
authors.lastname: Øvrebø
mesh_terms: D000230:Adenocarcinoma / Q000175:diagnosis / Q000473:pathology / Q000601:surgery*; D000236:Adenoma / Q000175:diagnosis / Q000473:pathology / Q000601:surgery*; D006801:Humans; D008866:Microsurgery / Q000009:adverse effects / Q000295:instrumentation / Q000379:methods*; D009364:Neoplasm Recurrence, Local; D011183:Postoperative Complications / Q000175:diagnosis; D020700:Proctoscopes; D011351:Proctoscopy / Q000009:adverse effects / Q000379:methods*; D012004:Rectal Neoplasms / Q000175:diagnosis / Q000473:pathology / Q000601:surgery*