OBJECTIVES: Transanal endoscopic microsurgery (TEM), a minimally invasive technique has been employed in the excision of benign and selected malignant rectal tumours since 1983. We present a single surgeon's series of 102 procedures. PATIENTS AND METHODS: A retrospective case note review of 102 procedures performed over a 6-year period between 1996 and 2001. RESULTS: One hundred and two TEM procedures were performed on 100 patients. 68 for adenomas, 19 potentially curative excisions for carcinoma, 13 palliative procedures for advanced carcinoma and 2 for solitary rectal ulcer syndrome (SRUS). Four adenomas recurred and were successfully treated by various procedures. None went on to develop malignancy, or a further recurrence. Of the cancers, six T1 and 10 T2 were excised with curative intent. Three T3 cancers were excised before endorectal ultrasound was available in the unit and went on to have definitive procedures. One T1 and two T2 carcinomas were not completely histologically excised. These patients were offered definitive procedure and there have been no recurrences. 11 patients underwent palliative TEM procedures, 2 went on to have a recurrence of symptoms. Both underwent a successful second TEM procedure. CONCLUSIONS: Although longer term follow up is still required, TEM appears to be an effective method of excising benign tumours and T1 carcinomas of the rectum. The role of TEM in the treatment of T2 carcinomas is, as yet, unclear and needs further evaluation although the results of our series and others are encouraging.
OBJECTIVES: Transanal endoscopic microsurgery (TEM), a minimally invasive technique has been employed in the excision of benign and selected malignant rectal tumours since 1983. We present a single surgeon's series of 102 procedures. PATIENTS AND METHODS: A retrospective case note review of 102 procedures performed over a 6-year period between 1996 and 2001. RESULTS: One hundred and two TEM procedures were performed on 100 patients. 68 for adenomas, 19 potentially curative excisions for carcinoma, 13 palliative procedures for advanced carcinoma and 2 for solitary rectal ulcer syndrome (SRUS). Four adenomas recurred and were successfully treated by various procedures. None went on to develop malignancy, or a further recurrence. Of the cancers, six T1 and 10 T2 were excised with curative intent. Three T3 cancers were excised before endorectal ultrasound was available in the unit and went on to have definitive procedures. One T1 and two T2 carcinomas were not completely histologically excised. These patients were offered definitive procedure and there have been no recurrences. 11 patients underwent palliative TEM procedures, 2 went on to have a recurrence of symptoms. Both underwent a successful second TEM procedure. CONCLUSIONS: Although longer term follow up is still required, TEM appears to be an effective method of excising benign tumours and T1 carcinomas of the rectum. The role of TEM in the treatment of T2 carcinomas is, as yet, unclear and needs further evaluation although the results of our series and others are encouraging.
Authors: Jeonghee Han; Gyoung Tae Noh; Chinock Cheong; Min Soo Cho; Hyuk Hur; Byung Soh Min; Kang Young Lee; Nam Kyu Kim Journal: World J Surg Date: 2017-09 Impact factor: 3.352
Authors: Nik Dekkers; Hao Dang; Jolein van der Kraan; Saskia le Cessie; Philip P Oldenburg; Jan W Schoones; Alexandra M J Langers; Monique E van Leerdam; Jeanin E van Hooft; Yara Backes; Katarina Levic; Alexander Meining; Giorgio M Saracco; Fabian A Holman; Koen C M J Peeters; Leon M G Moons; Pascal G Doornebosch; James C H Hardwick; Jurjen J Boonstra Journal: Surg Endosc Date: 2022-06-30 Impact factor: 4.584
Authors: Antonio Maya; Andrew Vorenberg; Myrian Oviedo; Giovanna da Silva; Steven D Wexner; Dana Sands Journal: Surg Endosc Date: 2013-12-24 Impact factor: 4.584
Authors: G Baatrup; H Elbrønd; P Hesselfeldt; P Wille-Jørgensen; P Møller; B Breum; N Qvist Journal: Int J Colorectal Dis Date: 2007-07-21 Impact factor: 2.571