title: Transanal Endoscopic Operation for Benign Rectal Lesions and T1 Carcinoma.
abstract: OBJECTIVE
  Transanal endoscopic operation (TEO) is a minimally invasive technique used for local excision of benign and selected malignant rectal lesions. The purpose of this study was to investigate the feasibility, safety, and oncological outcomes of the procedure and to report the experience in 3 centers.
  
  
  METHODS
  Retrospective review of a prospectively collected database was performed of all patients with benign lesions or ≤cT1N0 rectal cancer who underwent TEO with curative intent at 3 Belgian centers (2012 through 2014).
  
  
  RESULTS
  Eighty-three patients underwent 84 TEOs for 89 rectal lesions (37 adenomas, 43 adenocarcinomas, 1 gastrointestinal stromal tumor, 1 lipoma, 2 neuroendocrine tumors, and 5 scar tissues). Operative time was associated with lesion size (P< .001). Postoperative complications occurred in 13 patients: 7 hemorrhages, 1 urinary tract infection, 1 urinary retention, 2 abscesses, 1 anastomotic stenosis, and 1 entrance into the peritoneal cavity. Median hospital stay was 3 days (range, 1-8). During a median follow-up of 13 months (range, 2-27), there was 1 recurrence.
  
  
  CONCLUSIONS
  Although longer follow-up is still necessary, TEO appears to be an effective method of excising benign tumors and low-risk T1 carcinomas of the rectum. However, TEO should be considered as part of the diagnostic work-up. Furthermore, the resected specimen of a TEO procedure allows adequate local staging in contrast to an endoscopic piecemeal excision. Nevertheless, definitive histology must be appreciated, and in case of unfavorable histology, radical salvage resection still has to be performed.
authors.affiliation: Department of General and Digestive Surgery, Groeninge Hospital, Kortrijk, Belgium.
authors.forename: Mathieu
authors.initials: M
authors.lastname: D'Hondt
authors.affiliation: Department of General and Digestive Surgery, Groeninge Hospital, Kortrijk, Belgium.
authors.forename: Emi
authors.initials: E
authors.lastname: Yoshihara
authors.affiliation: Department of General and Digestive Surgery, Jan Yperman Hospital, Ieper, Belgium.
authors.forename: Lieven
authors.initials: L
authors.lastname: Dedrye
authors.affiliation: Department of General and Digestive Surgery, OLV van Lourdes Hospital, Waregem, Belgium.
authors.forename: Koen
authors.initials: K
authors.lastname: Vindevoghel
authors.affiliation: Department of General and Digestive Surgery, Groeninge Hospital, Kortrijk, Belgium.
authors.forename: Frederiek
authors.initials: F
authors.lastname: Nuytens
authors.affiliation: Interdisciplinary Research Center, Catholic University Leuven, Kortrijk, Belgium.
authors.forename: Hans
authors.initials: H
authors.lastname: Pottel
mesh_terms: D000230:Adenocarcinoma / Q000473:pathology / Q000601:surgery; D000236:Adenoma / Q000473:pathology / Q000601:surgery; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D046152:Gastrointestinal Stromal Tumors / Q000473:pathology / Q000601:surgery; D006801:Humans; D007902:Length of Stay; D008067:Lipoma / Q000473:pathology / Q000601:surgery; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local; D018358:Neuroendocrine Tumors / Q000473:pathology / Q000601:surgery; D011183:Postoperative Complications; D012004:Rectal Neoplasms / Q000473:pathology / Q000601:surgery*; D012189:Retrospective Studies; D000067368:Transanal Endoscopic Surgery
keywords: Benign rectal lesion; Early rectal cancer; Transanal endoscopic operation