Transanal endoscopic microsurgery for rectal cancer

If curation is intended for rectal cancer, total mesorectal excision with autonomic nerve preservation (TME) is the gold standard. Transanal resection is tempting because of low mortality and morbidity rates. However, inferior tumour control, provoked by the limitations of the technique, resulted in...

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Bibliographic Details
Published in:European journal of cancer (1990) 2002-05, Vol.38 (7), p.904-910
Main Authors: de Graaf, E.J.R, Doornebosch, P.G, Stassen, L.P.S, Debets, J.M.H, Tetteroo, G.W.M, Hop, W.C.J
Format: Article
Language:English
Subjects:
Adult
Aged
Aged, 80 and over
Blood Loss, Surgical
Colonoscopy - methods
Colonoscopy - mortality
Female
Follow-Up Studies
Humans
Length of Stay
Local excision
Local therapy
Male
Microsurgery - methods
Microsurgery - mortality
Middle Aged
Minimally invasive surgery
Rectal cancer
Rectal Neoplasms - surgery
Rectal tumour
Time Factors
Transanal endoscopic microsurgery (TEM)
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Summary:If curation is intended for rectal cancer, total mesorectal excision with autonomic nerve preservation (TME) is the gold standard. Transanal resection is tempting because of low mortality and morbidity rates. However, inferior tumour control, provoked by the limitations of the technique, resulted in its cautious application and use mainly for palliation. Transanal endoscopic microsurgery (TEM) is a minimal invasive technique for the local resection of rectal tumours. It is a one-port system, introduced transanally. An optical system with a 3D-view, 6-fold magnification and resolution as the human eye, together with the creation of a stabile pneumorectum, and specially designed instruments allow full-thickness excision under excellent view and a proper histological examination. The technique can also be applied for larger and more proximal tumours. Mortality, morbidity as well as incomplete excision rates are minimal. Local recurrence and survival rates seem comparable to TME in early rectal cancer. TEM is the method of choice when local resection of rectal cancer is indicated. Results justify a re-evaluation of the indications for the local excision of rectal cancer with a curative intent.
ISSN:0959-8049
1879-0852
DOI:10.1016/S0959-8049(02)00050-3