title: Transanal endoscopic microsurgery in treatment of rectal adenomas and T1 low-risk carcinomas.
abstract: BACKGROUND
  Transanal endoscopic microsurgery as a local therapy option for rectal neoplasms is a tissue-sparing technique that protects the anal sphincter. The present retrospective analysis reports the course of observation after local excision of adenomas and T1 low-risk carcinomas using transanal endoscopic microsurgery.
  
  
  METHODS
  In a retrospective analysis we examined data on 279 patients for local recurrence. A total of 144 patients had a rectal adenoma (n = 103) or a R0 resection of low-risk T1 carcinomas (n = 41). In this collective, we also examined parameters concerning perioperative management, complications, intraoperative blood loss and duration of hospital stay.
  
  
  RESULTS
  Patients with adenoma were on average 64.9 (range 37 to 90) years old; 83.5% of the adenomas were located 3 to 11 cm from the anocutaneous line. In adenoma patients the recurrence rate was 2.9% for an observation period of 21.8 months. The postoperative course was without any complications in 98.1% of patients.Patients with T1 low-risk carcinoma were 64.6 (range 30 to 89) years old. In all cases, an R0 resection could be performed. The recurrence rate was 9.8% for an observation period of 34.4 months. In this group the postoperative course was free of complications in 97.6% of patients.
  
  
  CONCLUSIONS
  The high efficacy of transanal endoscopic microsurgery ensures minimally invasive treatment of adenomas and low-risk T1 carcinomas with low complication rates and a low rate of therapeutic failure.
authors.affiliation: Department of Cardiology, Bad Krozingen Heart Center, Südring 15, 79189, Bad Krozingen, Germany.
authors.forename: Michael
authors.initials: M
authors.lastname: Amann
authors.forename: Ali
authors.initials: A
authors.lastname: Modabber
authors.forename: Jens
authors.initials: J
authors.lastname: Burghardt
authors.forename: Christian
authors.initials: C
authors.lastname: Stratz
authors.forename: Claudius
authors.initials: C
authors.lastname: Falch
authors.forename: Gerhard F
authors.initials: GF
authors.lastname: Buess
authors.forename: Andreas
authors.initials: A
authors.lastname: Kirschniak
mesh_terms: D000236:Adenoma / Q000473:pathology / Q000601:surgery*; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001003:Anal Canal / Q000473:pathology / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008866:Microsurgery; D008875:Middle Aged; D019060:Minimally Invasive Surgical Procedures; D057605:Natural Orifice Endoscopic Surgery; D060787:Neoplasm Grading; D009364:Neoplasm Recurrence, Local / Q000175:diagnosis*; D009367:Neoplasm Staging; D012004:Rectal Neoplasms / Q000473:pathology / Q000601:surgery*; D012189:Retrospective Studies; D012307:Risk Factors; D016896:Treatment Outcome