Clinical efficacy of video-assisted gasless transanal endoscopic microsurgery (TEM) for rectal carcinoid tumor

Background: We used video-assisted gasless transanal endoscopic microsurger y (TEM) to evaluate 12 consecutive patients for carcinoid tumor with pathol ogically typical features in the proximal rectum. The study parameters incl uded feasibility. results and final outcome. Methods: A scope with an optical angle of 25 degrees and a 7-mm diameter wa s used for TEM. The carcinoid tumor was resected in full thickness. Primary closure was accomplished using a running suture of 3-0 braided absorbable suture. Results: The tumor in these patients was < 15 mm in diameter. It was locali zed within the submucosal laver on the oral side from the peritoneal reflec tion and unreachable via Park's transanal approach. The mean duration of th e operation was 63 rlin. The postoperative course in all patients was free from significant complications, and all patients were discharged within I w eek. None of the patients had postoperative pain or required sedatives. Conclusion: Video-assisted gasless TEM is a simple and minimally invasive p rocedure to treat benign carcinoid tumors in the proximal rectum.