IS TRANSANAL ENDOSCOPIC MICROSURGERY (TEM) A VALID TREATMENT FOR RECTAL TUMORS

Background: In 1983 G. Buess, in Germany, developed transanal endoscop ic microsurgery (TEM), a new minimally invasive technique for the trea tment of rectal tumors. Methods: Rectal lesions are excised through a modified rectoscope of 40 mm in diameter under stereoscopic control in the gas-dilated rectal cavity. Full-thickness excision, partial-wall excision, or mucosectomy can be performed, Seventy-one patients were t reated with the TEM technique in our department. Major complications w ere observed in one patient (1.4%). No mortality was reported. Results : Histological examination revealed 40 (56.3%) villous adenomas, 6 (8. 4%) PT1; 17 (23.9%) pT2: 5 (7%) pT3 carcinomas; and 3 ((4.2%) other le sions. The recurrence rate was 2.8% or adenomas and 2.8% for carcinoma s. The overall survival at mean follow-up of 17 months was 96.4%. Conc lusions: The advantages of TEM are less or no postoperative pain, unre stricted mobility, short hospitalization, quick rehabilitation, and ab sence of skin scars.