Transanal Endoscopic Microsurgery: A Review

Since G. Buess introduced transanal endoscopic microsurgery (TEM) in 1984, the technique has been increasingly used in the management of rectal adenomas and in selected cases of rectal carcinoma, with good results. For the purposes of this review a Medline literature search was performed in order to locate articles on the indications and the clinical and functional results of TEM. Further articles were obtained by manually searching the reference lists of identified papers. Emphasis was placed on reports from the past decade. Reviewing these papers, TEM appears to be an effective method of excising benign tumors and selected T1 carcinomas of the rectum. The place of this technique in the resection of advanced carcinomas has yet to be properly evaluated but its use for this indication has produced similar or better results than radical techniques. In conclusion, TEM is a safe procedure and can achieve good results in terms of local tumor resection, with lower recurrences rates, lower complication rates, and better survival rates than those of radical techniques.

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