title: Transanal Endoscopic Microsurgery for Patients With Rectal Tumors: A Single Institution's Experience.
abstract: OBJECTIVE
  The purpose of this study was to look at our complication rates and recurrence rates, as well as the need for further radical surgery, in treating patients with benign and early malignant rectal tumors by using transanal endoscopic microsurgery (TEM).
  
  
  METHODS
  Our study included 130 patients who had undergone TEM for rectal adenomas and early rectal cancer from December 2009 to December 2015 at the Department of Surgical Oncology, National Cancer Institute, Lithuania. Patients underwent digital and endoscopic evaluation with multiple biopsies. For preoperative staging, pelvic magnetic resonance imaging or endorectal ultrasound was performed. We recorded the demographics, operative details, final pathologies, postoperative lengths of hospital stay, postoperative complications, and recurrences.
  
  
  RESULTS
  The average tumor size was 2.8 ± 1.5 cm (range, 0.5-8.3 cm). 102 benign (78.5%) and 28 malignant tumors (21.5%) were removed. Of the latter, 23 (82.1%) were pT1 cancers and 5 (17.9%) pT2 cancers. Of the 5 patients with pT2 cancer, 2 underwent adjuvant chemoradiotherapy, 1 underwent an abdominoperineal resection, 1 refused further treatment and 1 was lost to follow up. No intraoperative complications occurred. In 7 patients (5.4%), postoperative complications were observed: urinary retention (4 patients, 3.1%), postoperative hemorrhage (2 patients, 1.5%), and wound dehiscence (1 patient, 0.8%). All complications were treated conservatively. The mean postoperative hospital stay was 2.3 days.
  
  
  CONCLUSIONS
  TEM in our experience demonstrated low complication and recurrence rates. This technique is recommended for treating patients with a rectal adenoma and early rectal cancer and has good prognosis.
authors.affiliation: Centre of Oncosurgery, National Cancer Institute, Vilnius, Lithuania.
authors.forename: Audrius
authors.initials: A
authors.lastname: Dulskas
authors.affiliation: Centre of Oncosurgery, National Cancer Institute, Vilnius, Lithuania.
authors.forename: Alfredas
authors.initials: A
authors.lastname: Kilius
authors.affiliation: Centre of Oncosurgery, National Cancer Institute, Vilnius, Lithuania.
authors.forename: Kestutis
authors.initials: K
authors.lastname: Petrulis
authors.affiliation: Centre of Oncosurgery, National Cancer Institute, Clinic of Internal, Family Medicine and Oncology, Faculty of Medicine, Vilnius, Lithuania.
authors.forename: Narimantas E
authors.initials: NE
authors.lastname: Samalavicius
keywords: Early rectal cancer; Rectal adenoma; Recurrence; Transanal endoscopic microsurgery