Surgical Endoscopy

, Volume 9, Issue 1, pp 56–60

Transanal endoscopic microsurgery

Results of the initial ten cases
  • K. S. Khanduja
Original Articles

DOI: 10.1007/BF00187887

Cite this article as:
Khanduja, K.S. Surg Endosc (1995) 9: 56. doi:10.1007/BF00187887


Transanal endoscopic microsurgery (TEM) permits precise excision of favorable tumors from the mid and proximal rectum, thus avoiding transsacral and low anterior resection in select cases. Ten patients underwent TEM resection of rectal tumors by a single surgeon between April 1992 and August 1993. All patients first underwent endorectal ultrasound. Villous adenomas ranging from 3.2 to 4.5 cm in size (mean, 3.9 cm) in eight patients and T1 adenocarcinomas of 1.5 and 2.5 cm (mean, 2 cm) in two patients were excised. Resection was performed using the mucosectomy method in three and by full-thickness excision in seven patients. Distal extent of tumors ranged from 6 to 11 cm from the anal verge. The operative time in these initial ten cases ranged from 75 to 220 min (mean, 138 min). Estimated blood loss ranged from 0 to 550 cc (mean, 85 cc). Complications occurred in two patients (pseudomembranous colitis; fever of unknown origin). The mean length of hospital stay was 2.7 days. To date, one tumor has recurred, requiring an abdominoperineal resection. In no case was conversion to conventional method of resection necessary at the time of TEM resection. TEM is a safe and effective method for resecting favorable tumors in select cases.

Key words

Transanal endoscopic microsurgeryRectal tumorsVillous adenomaRectal adenocarcinomaEndoscopic surgery

Copyright information

© Springer-Verlag New York Inc 1995

Authors and Affiliations

  • K. S. Khanduja
    • 1
  1. 1.Department of SurgeryMount Carmel Medical CenterColumbusUSA
  2. 2.ColumbusUSA