title: [Transanal endoscopic microsurgery (TEM) our experience].
abstract: BACKGROUND
  The purpose of this paper is to present our experience with transanal endoscopic microsurgery (TEM) as an operative approach in a selected group of patients with rectal tumours.
  
  
  METHODS
  We present a retrospective study of 80 patients operated for rectal tumour using TEM. Specific preoperative and postoperative indicators were gathered and statistically evaluated. We assessed histological examination before the surgery and definitive histology of the resected tumour, resection depth and basic demographic data of our patients.
  
  
  RESULTS
  Our experience suggests that there is no significant difference between the age of patients according to sex, even if malignant and benign tumours are assessed separately. The majority of our operated patients were male patients, mean age of 64 years who were primarily referred to our department because of bleeding low-grade adenomas of the rectum. In 17 patients a malignant tumour was diagnosed based on final histopathologic examination. None of them had signs of malignancy before the surgery.
  
  
  CONCLUSIONS
  In the hands of an experienced surgeon, TEM is a feasible option of radical removal of rectal, locally not advanced malignancies if within reach of TEM rectoscope. TEM is a safe procedure that does not result in any alteration of rectal sphincter functions. Possible false negative preoperative benign diagnosis leads us to approach radical removal of the tumour with full wall thickness resection. Although the posterior aspect of the rectum is an optimal location for the rectoscope, anterior tumours were found in almost one half of our patients. Considering technical feasibility of the rectal wall suture, the base of the tumour should not extend beyond one half of the rectal circumference. Low non-stenotising noninvasive tumours of the rectum are suitable for TEM. Our good results are particularly due to strict patient selection criteria, mastering the operating technique and long-time experience.
  
  
  BACKGROUND
  transanal endoscopic microsurgery (TEM) benign rectal tumours rectal cancer.
authors.forename: O
authors.initials: O
authors.lastname: Robek
authors.forename: V
authors.initials: V
authors.lastname: Čan
authors.forename: T
authors.initials: T
authors.lastname: Svoboda
authors.forename: B
authors.initials: B
authors.lastname: Hemmelová
authors.forename: Z
authors.initials: Z
authors.lastname: Kala
authors.forename: R
authors.initials: R
authors.lastname: Hrivnák
mesh_terms: D000236:Adenoma / Q000601:surgery; D002277:Carcinoma / Q000601:surgery; D018153:Czech Republic; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications; D012004:Rectal Neoplasms / Q000601:surgery*; D012189:Retrospective Studies; D000067369:Transanal Endoscopic Microsurgery