TRANSANAL ENDOSCOPIC MICROSURGERY - INITIAL EXPERIENCE FROM 3 CENTERSIN THE UNITED-KINGDOM

Over a 28-month period, 100 transanal endoscopic microsurgical excisio ns of rectal tumours were carried out in three centres. The histologic al diagnosis was benign adenoma in 77 and invasive adenocarcinoma in 2 3. Complete excision of the tumour with histological confirmation was achieved in 70 (91 per cent) of the adenomas and in all but one of the carcinomas. Of the carcinomas, 18 were recognized before operation an d the remaining five were diagnosed on postoperative histology. Of the patients with carcinoma, one had immediate further surgery, nine had radiotherapy and 13 had no extra treatment. To date, four patients hav e had a recurrence of villous adenoma, and two of the patients treated for invasive carcinoma have had local recurrence. These initial resul ts of transanal endoscopic microsurgery in the UK compare well with th ose of earlier reports, indicating that the technique has a useful pla ce in the management of sessile adenomas of the mid and upper third of the rectum, and of some carefully selected carcinomas.