BACKGROUND: Transanal endoscopic microsurgery (TEM) can access the whole rectum up to 20 cm from the anal verge. Due to its excellent view and accurate dissection, TEM is useful for the removal of adenoma and selected low risk cancers of the rectum. We report our experience with the first 70 patients presenting. METHODS: A prospective descriptive study of 70 patients treated for rectal tumor with TEM from December 99 until October 2002 at Haukeland University Hospital. RESULTS: TEM was performed in 37 men and 33 women, median age 70.5 (19-90) years, for anticipated adenoma (n = 64), adenocarcinoma (n = 3), rectal ulcer (n = 1), and re-resection after snare resection of rectal polyp with adenocarcinoma (n = 1) and carcinoid tumor (n = 1). The median observation time was 12 (1-33) months. The distance from the anal verge to the lower tumor border was 5.5 (2.5-14) cm. The median resected area was 15.4 (1.5-132) cm(2). 56 of the 64 anticipated adenomas were true adenoma, resected without recurrences; 8 (12.5%) were unexpected adenocarcinoma. Three of these underwent a secondary rectal resection and 5 patients have been observed without recurrence. Of the 3 patients with known adenocarcinoma, there was one recurrence which was treated with a secondary curative rectal resection. CONCLUSIONS: TEM can access tumors in the whole rectum. Large tumors may be removed with low frequency of per- and postoperative complications and short hospital stay. TEM is highly useful for removal of rectal adenoma. A role for primary treatment of selected low-risk rectal cancers may emerge. Copyright (c) 2005 S. Karger AG, Basel.
BACKGROUND: Transanal endoscopic microsurgery (TEM) can access the whole rectum up to 20 cm from the anal verge. Due to its excellent view and accurate dissection, TEM is useful for the removal of adenoma and selected low risk cancers of the rectum. We report our experience with the first 70 patients presenting. METHODS: A prospective descriptive study of 70 patients treated for rectal tumor with TEM from December 99 until October 2002 at Haukeland University Hospital. RESULTS: TEM was performed in 37 men and 33 women, median age 70.5 (19-90) years, for anticipated adenoma (n = 64), adenocarcinoma (n = 3), rectal ulcer (n = 1), and re-resection after snare resection of rectal polyp with adenocarcinoma (n = 1) and carcinoid tumor (n = 1). The median observation time was 12 (1-33) months. The distance from the anal verge to the lower tumor border was 5.5 (2.5-14) cm. The median resected area was 15.4 (1.5-132) cm(2). 56 of the 64 anticipated adenomas were true adenoma, resected without recurrences; 8 (12.5%) were unexpected adenocarcinoma. Three of these underwent a secondary rectal resection and 5 patients have been observed without recurrence. Of the 3 patients with known adenocarcinoma, there was one recurrence which was treated with a secondary curative rectal resection. CONCLUSIONS: TEM can access tumors in the whole rectum. Large tumors may be removed with low frequency of per- and postoperative complications and short hospital stay. TEM is highly useful for removal of rectal adenoma. A role for primary treatment of selected low-risk rectal cancers may emerge. Copyright (c) 2005 S. Karger AG, Basel.
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
Authors: Frank J C van den Broek; Eelco J R de Graaf; Marcel G W Dijkgraaf; Johannes B Reitsma; Jelle Haringsma; Robin Timmer; Bas L A M Weusten; Michael F Gerhards; Esther C J Consten; Matthijs P Schwartz; Maarten J Boom; Erik J Derksen; A Bart Bijnen; Paul H P Davids; Christiaan Hoff; Hendrik M van Dullemen; G Dimitri N Heine; Klaas van der Linde; Jeroen M Jansen; Rosalie C H Mallant-Hent; Ronald Breumelhof; Han Geldof; James C H Hardwick; Pascal G Doornebosch; Annekatrien C T M Depla; Miranda F Ernst; Ivo P van Munster; Ignace H J T de Hingh; Erik J Schoon; Willem A Bemelman; Paul Fockens; Evelien Dekker Journal: BMC Surg Date: 2009-03-13 Impact factor: 2.102