[Transanal endoscopic microsurgery for the treatment of localized rectal neoplasms].
OBJECTIVE
To investigate the therapeutic effect of transanal endoscopic microsurgery (TEM) for localized rectal neoplasms.


METHODS
Seventy-five patients with localized rectal neoplasms were treated by using TEM between April 2006 and December 2008. The clinical data was summarized and analyzed retrospectively to report the therapeutic effect of TEM in these cases.


RESULTS
The mean diameter of the rectal lesions was (1.6 +/- 0.8) cm (range, 0.5-5.0 cm). The average distance of lesions from the anal verge was (7.6 +/- 2.8) cm (range, 5-20 cm). Locations of the lesions at the rectal wall: 25 located at the anterior wall, 24 at the posterior wall, 14 at the left wall and 12 at the right wall. Surgical procedures included the transmural excision (64 cases) and the submucosal excision with partial muscular layer excision (11 cases) was performed. The average operating time was (73.7 +/- 32.1) min (range, 30-180 min). The mean operative blood loss was (9.8 +/- 7.7) ml (range, 3-50 ml). The postoperative pathological examination identified 28 cases of rectal adenoma, 25 rectal adenocarcinoma or carcinomatous changes of adenoma (14 cases with phase Tis tumor, 5 cases T1 and 6 cases T2), 7 rectal carcinoid and 15 cases of inflammatory polyps or others. Surgical margins of all specimens were negative. Postoperative complications occurred in 4 cases (5.3%), included 2 cases of anal hemorrhage, 1 case of pulmonary infection and 1 urinary infection. The average postoperative hospital stay was (3.4 +/- 1.2) d (range, 2-7 d). All the patients were followed-up for a mean period of 8. 4 months (range, 3-26 months), no tumor recurrence or metastasis was observed.


CONCLUSIONS
Being a kind of minimally invasive surgery, TEM shows advantages of decreased blood loss, better therapeutic effect and faster recovery, and it is a better choice of procedure for local excision for rectal neoplasms.
Qiu
Hui-zhong
HZ
Department of General Surgery, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing 100730, China. qiuhzpumc@yahoo.com.cn
Lin
Guo-le
GL
Zhou
Jiao-lin
JL
Xiao
Yi
Y
Wu
Bin
B
D000328:Adult; D000368:Aged; D001003:Anal Canal / Q000601:surgery; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D019060:Minimally Invasive Surgical Procedures; D011351:Proctoscopy / Q000379:methods*; D012004:Rectal Neoplasms / Q000601:surgery*; D012189:Retrospective Studies; D016896:Treatment Outcome