Transanal endoscopic microsurgery – lessons from a single UK centre series

Lloyd, G. M.; Sutton, Christopher; Marshall, Leslie-Jayne; Baragwanath, P.; Jameson, J. S.; Scott, A. D. N.

doi:10.1046/j.1463-1318.2002.00389.x

Cited by 42 publications

(34 citation statements)

References 20 publications

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“…Various published studies have shown a shorter length of hospitalisation in patients undergoing TEM, with an average in patient stay of around 5 days (range 3–8.2) [5, 9, 18,23,24,25, 28,30,31,32,33,34,35,36,37]. This compares favourably with 14.5 days quoted for open procedures [25].…”

Section: Resultsmentioning

confidence: 87%

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Transanal Endoscopic Microsurgery: Where Are We Now?

Maslekar¹,

Beral²,

White³

et al. 2006

Dig Surg

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Aims: This review of literature aimed to assess the role and establish the current status of transanal endoscopic microsurgery (TEM) in the management of benign and malignant rectal lesions. Methods: Areview of the literature was undertaken through the Medline database and by cross-referencing previous publications, thus identifying 54 relevant publications on TEM in the management of rectal lesions. Aggregated results of various parameters were calculated but statistical comparisons deemed unsuitable due to heterogeneity of data. Results: The TEM procedure is associated with good functional results, morbidity of 4% and zero procedure-related mortality. The local recurrence rates after TEM excision is 4.5% (range 0–14) for benign rectal lesions, 6% (0–13) for T₁ cancers, 14% (range 0–50) for T₂ cancers and 20% (range 14–67%) for T₃ cancers. Local recurrences after TEM can be surgically salvaged with good disease free survival rates. Conclusions: The TEM procedure clearly offers the benefits of good exposure of the operative field allowing extremely precise dissection and access to high rectal lesions unresectable by other methods. For pTis and low risk pT₁ lesions, the oncological results are comparable to the more traditional formal resection. The routine use of TEM for high-risk pT₁ and higher stage lesions is not an oncologically sound choice at the present moment.

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Section: Resultsmentioning

confidence: 87%

“…Several published reports have consistently demonstrated these benefits [5, 9, 18,23,24,25,26,27,28,29,30,31,32,33], which hold true for both the older and the younger patients.…”

Section: Resultsmentioning

confidence: 88%

Transanal Endoscopic Microsurgery: Where Are We Now?

Maslekar¹,

Beral²,

White³

et al. 2006

Dig Surg

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“…1.7 3.5 d.n.o Neary et al [24] 21 0 4.7 d.n.o Katti et al [25] 58 7 10 34 Vorobiev et al [26] 113 -8.3 29.5 Bretagnol et al [27] 148 14.9 7.6 33 Endreseth et al [28] 64 20 13 24 Zacharakis et al [29] 48 4.2 6.3 37 Schäfer et al [30] 33 18 12 36.4 Røkke et al [31] 56 10 0 12 Guerrieri et al [32] 530 -4.3 44 McCloud et al [33] 75 37.3 16 31 Whitehouse et al [34] 146 5.5 4.8 39 Platell et al [35] 62 -2.4 24 Lloyd et al [36] 68 9 5.9 28.7 Ganai et al [37] [31] did not observe adenoma recurrence after 12 mo follow-up in a series of patients in whom the residual adenoma in surgical margin was 10%.…”

Section: Followup (Mo)mentioning

confidence: 99%

Surgical resection of rectal adenoma: A rapid review

Casadesús¹

2009

WJG

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Transanal excision (TE), endoscopic transanal resection (ETAR) and transanal endoscopic microsurgery (TEM) can be used to remove adenomatous polyps. However, their use is limited by the size or location of the tumor. TE is limited to the lower rectum, TEM offers better access to lesions in the middle and upper rectum, and ETAR is used less frequently than it deserves for resection of rectal lesions.

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“…Nevertheless, these techniques demand experience and, in consequence, must be performed in reference centers where a larger number of patients are available, facing that the surgeon training is mandatory and the small frequency of the indications is a reality [41][42][43][44]. Because of the necessity of having specific instruments and also the particular technical aspects, this method demands good training for the obtention of satisfactory results [45][46][47]. It was described that in 11 tumors located up to 4 cm of the anorectal line, a surgical conversion was necessary because of technical difficulties [48].…”

Section: Discussionmentioning

confidence: 99%