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Clin Colon Rectal Surg 2002; 15(2): 157-162
DOI: 10.1055/s-2002-32064
Copyright © 2002 by Thieme Medical Publishers, Inc., 333 Seventh Avenue, New York, NY 10001, USA. Tel.: +1(212) 584-4662

Transanal Endoscopic Microsurgery

Theodore John Saclarides
  • Department of General Surgery, Rush Medical Center, Rush-Presbyterian-St. Luke's Medical Center, Chicago, IL
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Publication History

Publication Date:
06 June 2002 (online)

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ABSTRACT

Transanal endoscopic microsurgery (TEM) utilizes a closed, airtight system that provides constant rectal distension, improved visibility, and longer reach than conventional instrumentation. Virtually any rectal adenoma and properly selected cancers can be removed with this technique. It is safe, complications are few, and most patients can be treated on an outpatient basis. Once TEM has been mastered, it may become the technique of choice for locally excising rectal neoplasms. Complications are few; however, they are not seen any less frequently than conventional local excision. Such complications include bleeding, urinary retention, and temporary soilage just to name a few. Regarding TEM excision of cancers, strict selection criteria must be satisfied. TEM is best suited for TI cancers. TEM should not replace low anterior resection or abdominoperineal resection for those cancers that have either deep penetration into the rectal wall or lymph node metastases.

KEYWORDS

Transanal excision - rectal adenomas - cancers

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