Endoscopic and Transanal Approaches for Acute Anal and Rectal Cancers

  • John McClellan
  • Anjali S. Kumar


In the management of early-stage rectal cancer, several techniques can be considered for local excision: total mesorectal excision (TME), transanal endoscopic microsurgery (TEM), transanal minimally invasive surgery (TAMIS), endoscopic mucosal resection (EMR)/endoscopic submucosal dissection (ESD), and robotic surgical approaches. Endoscopic and transanal approaches allow patients to avoid the morbidity of radical surgery (proctectomy with total mesorectal excision). This article provides an overview of these local excision techniques and reviews the indications for their use. While it is important for the acute care surgeon to know of these modalities, expertise may be held by an advanced gastroenterologist or a colorectal surgeon, so consultation of these specialists can be thoughtfully considered.


Colorectal surgery Anorectal malignancies Transanal excision Endoscopy Minimally invasive surgery Anorectal bleeding Rectal obstruction 


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Copyright information

© Springer Nature Switzerland AG 2019

Authors and Affiliations

  • John McClellan
    • 1
  • Anjali S. Kumar
    • 2
  1. 1.Madigan Army Medical CenterTacomaUSA
  2. 2.Elson Clinical Education, Surgery, Elson S. Floyd College of MedicineWashington State UniversityEverett/Spokane/Tri-Cities/VancouverUSA

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