OBJECTIVE: Transanal endoscopic microsurgery (TEM) has become increasingly common in the management of rectal adenomas and also in selected cases of rectal carcinomas. The aim of this study was to assess the results in a consecutive series of patients after introducing the TEM technique. PATIENTS AND METHODS: All 58 patients operated with TEM from January 1996 to January 1999 were evaluated in a retrospective review. Forty-eight patients answered a clinically validated questionnaire a median of 22 months after TEM. Eighty patients who had undergone transanal excision and 12 who had undergone York Mason's procedure served as a reference group with respect to recurrence rates. RESULTS: The complication rate was 5% (immediate) and 14% (long-term). The overall 30-day mortality rate was zero. An impairment of continence was seen in 18 (37%) patients. Of these, all 18 experienced varying degree of incontinence to liquid stool, 14 also to flatus and 5 of them even to solid stool. The recurrence rate was 11% in adenomas and 14% in cancers; T1, 1 (10%) recurrence and T2, 1 (50%) recurrence. There was a correlation between operating time and impairment of continence as well as recurrence rate. CONCLUSION: TEM is a safe procedure, having a low recurrence rate and an acceptable functional outcome.
OBJECTIVE: Transanal endoscopic microsurgery (TEM) has become increasingly common in the management of rectal adenomas and also in selected cases of rectal carcinomas. The aim of this study was to assess the results in a consecutive series of patients after introducing the TEM technique. PATIENTS AND METHODS: All 58 patients operated with TEM from January 1996 to January 1999 were evaluated in a retrospective review. Forty-eight patients answered a clinically validated questionnaire a median of 22 months after TEM. Eighty patients who had undergone transanal excision and 12 who had undergone York Mason's procedure served as a reference group with respect to recurrence rates. RESULTS: The complication rate was 5% (immediate) and 14% (long-term). The overall 30-day mortality rate was zero. An impairment of continence was seen in 18 (37%) patients. Of these, all 18 experienced varying degree of incontinence to liquid stool, 14 also to flatus and 5 of them even to solid stool. The recurrence rate was 11% in adenomas and 14% in cancers; T1, 1 (10%) recurrence and T2, 1 (50%) recurrence. There was a correlation between operating time and impairment of continence as well as recurrence rate. CONCLUSION: TEM is a safe procedure, having a low recurrence rate and an acceptable functional outcome.
Authors: Dimitrios Dardamanis; Dimitrios Theodorou; George Theodoropoulos; Andreas Larentzakis; Maria Natoudi; Georgia Doulami; Christina Zoumpouli; Haridimos Markogiannakis; Stylianos Katsaragakis; George C Zografos Journal: World J Gastrointest Surg Date: 2011-04-27
Authors: Angelo Restivo; Luigi Zorcolo; Giuseppe D'Alia; Francesca Cocco; Andrea Cossu; Francesco Scintu; Giuseppe Casula Journal: Int J Colorectal Dis Date: 2015-08-23 Impact factor: 2.571
Authors: Stefan H E M Clermonts; Yu-Ting van Loon; Dareczka K Wasowicz; Barbara S Langenhoff; David D E Zimmerman Journal: J Gastrointest Surg Date: 2018-03-05 Impact factor: 3.452
Authors: S H E M Clermonts; Y T van Loon; A H W Schiphorst; D K Wasowicz; D D E Zimmerman Journal: Int J Colorectal Dis Date: 2017-09-13 Impact factor: 2.571
Authors: Lars Boenicke; Martin Fein; Marco Sailer; Christoph Isbert; Christoph-Tomas Germer; Andreas Thalheimer Journal: Int J Colorectal Dis Date: 2009-11-06 Impact factor: 2.571