title: Transanal endoscopic microsurgery for rectal cancer.
abstract: Since its introduction in the 1980s, total mesorectal excision (TME) has been the standard surgical technique for treating rectal cancer. This procedure involves removing the rectum and the surrounding envelope of fat along the plane of the mesorectal fascia. Resecting this embryological unit reduces the local recurrence rate by removing all local lymph nodes, including those with occult metastatic disease; however, this surgery is associated with mortality and morbidity. Complications include incontinence for patients given an anastomosis, long-term stoma formation, and sexual and bladder dysfunction. Local excision of rectal cancer using the transanal endoscopic microsurgery (TEM) technique is associated with fewer complications, and therefore, is used as an alternative in specific circumstances. We outline the technique, its indications, imaging appearances and complications.
authors.affiliation: Department of Radiology, Oxford University Hospitals NHS Trust, Headley Way, Oxford OX3 9DU, UK. Electronic address: andrew.slater@ouh.nhs.uk.
authors.forename: A
authors.initials: A
authors.lastname: Slater
authors.affiliation: Department of Radiology, Oxford University Hospitals NHS Trust, Headley Way, Oxford OX3 9DU, UK.
authors.forename: M
authors.initials: M
authors.lastname: Betts
authors.affiliation: Department of Radiology, Oxford University Hospitals NHS Trust, Headley Way, Oxford OX3 9DU, UK.
authors.forename: E M
authors.initials: EM
authors.lastname: Anderson
authors.affiliation: Department of Surgery, Oxford University Hospitals NHS Trust, Headley Way, Oxford OX3 9DU, UK.
authors.forename: C
authors.initials: C
authors.lastname: Cunningham
mesh_terms: D003952:Diagnostic Imaging; D006801:Humans; D008279:Magnetic Resonance Imaging; D011183:Postoperative Complications / Q000473:pathology*; D012004:Rectal Neoplasms / Q000473:pathology / Q000601:surgery*; D012007:Rectum / Q000473:pathology / Q000601:surgery; D000067369:Transanal Endoscopic Microsurgery