title: [Analysis of 32 patients with rectal adenoma undergoing transanal endoscopic microsurgery].
abstract: OBJECTIVE
  To evaluate the safety and outcomes after transanal endoscopic microsurgery (TEM)for rectal adenoma.
  
  
  METHODS
  Data of 32 patients undergoing TEM for rectal adenoma between September 2006 and February 2010 in the Ruijin Hospital were reviewed.
  
  
  RESULTS
  The adenoma diameter ranged from 0.6 to 10.0(2.3±1.2) cm. The mean operative time was 70(range,20-180) min. The estimated blood loss was less than 10 ml. There were no conversions to transabdominal procedure. Twenty-two(68.8%) patients underwent suturing of the wound, of whom 14 had full-thickness resection. Two patients had perforation into peritoneal cavity during full-thickness resection, which were repaired by continuous suturing and no postoperative leak occurred. R0 resection was achieved in 31(96.9%) patients. Postoperative pathology showed 12 simple adenomas, 10 adenomas with low grade intraepithelial neoplasia, 5 adenomas with high grade intraepithelial neoplasia, and 5 T1 focal carcinomas. Complications included rectal bleeding in 1 patient, acute urinary retention in 1 patient, and pulmonary infection in 1 patient. The postoperative stay was 4.5(3-8) days. The patients were followed-up for a period of 23 months(range, 2-43 months). There were 2 tumors recurred.
  
  
  CONCLUSIONS
  TEM is a safe and effective minimally invasive surgical technique for large rectal adenomas.
authors.affiliation: Department of Surgery, Shanghai Jiaotong University School of Medicine, Shanghai 200025, China.
authors.forename: Yong-gang
authors.initials: YG
authors.lastname: He
authors.forename: Yi
authors.initials: Y
authors.lastname: Han
authors.forename: Zhi-li
authors.initials: ZL
authors.lastname: Hua
authors.forename: Mou-bin
authors.initials: MB
authors.lastname: Lin
authors.forename: Hao-bo
authors.initials: HB
authors.lastname: Zhang
authors.forename: Ke-zhi
authors.initials: KZ
authors.lastname: Lv
authors.forename: Lu
authors.initials: L
authors.lastname: Yin
mesh_terms: D000236:Adenoma / Q000601:surgery*; D000368:Aged; D001003:Anal Canal / Q000601:surgery; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D011351:Proctoscopy / Q000379:methods*; D012004:Rectal Neoplasms / Q000601:surgery*; D012189:Retrospective Studies; D016896:Treatment Outcome