Abstract
The last three decades have witnessed significant improvements in the diagnosis, staging and treatment modalities of rectal tumors leading to a more tailored approach. One of the most clinically relevant advances is the development and diffusion of Transanal Endoscopic Microsurgery (TEM). TEM is a minimally invasive procedure that allows to perform a full thickness en bloc local excision of a rectal tumor down to the perirectal fatty tissue and to suture the rectal defect. It is performed under general or spinal anesthesia with very limited postoperative morbidity and mortality.
Even though TEM was initially conceived for the treatment of tumors located in the extraperitoneal rectum, there is increasing evidence that a full thickness TEM can be offered also to patients with intraperitoneal rectal cancers, with no increased morbidity and cancer-related mortality.
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References
Buess G, Hutterer F, Theiss J, Böbel M, Isselhard W, Pichlmaier H. A system for a transanal endoscopic rectum operation. Chirurg. 1984;55:677–80.
Suppiah A, Maslekar S, Alabi A, Hartley JE, Monson JR. Transanal endoscopic microsurgery in early rectal cancer: time for a trial? Colorectal Dis. 2008;10:314–27.
Bach SP, Hill J, Monson JR, et al. Association of Coloproctology of Great Britain and Ireland Transanal Endoscopic Microsurgery (TEM) Collaboration. A predictive model for local recurrence after transanal endoscopic microsurgery for rectal cancer. Br J Surg. 2009;96:280–90.
Lezoche E, Baldarelli M, Lezoche G, Paganini AM, Gesuita R, Guerrieri M. Randomized clinical trial of endoluminal locoregional resection versus laparoscopic total mesorectal excision for T2 rectal cancer after neoadjuvant therapy. Br J Surg. 2012;99(9):1211–8.
Arezzo A, Passera R, Saito Y, Sakamoto T, Kobayashi N, Sakamoto N, Yoshida N, Naito Y, Fujishiro M, Niimi K, Ohya T, Ohata K, Okamura S, Iizuka S, Takeuchi Y, Uedo N, Fusaroli P, Bonino MA, Verra M, Morino M. Systematic review and meta-analysis of endoscopic submucosal dissection versus transanal endoscopic microsurgery for large noninvasive rectal lesions. Surg Endosc. 2014;28:427–38.
Christoforidis D, Cho HM, Dixon MR, Mellgren AF, Madoff RD, Finne CO. Transanal endoscopic microsurgery versus conventional transanal excision for patients with early rectal cancer. Ann Surg. 2009;249(5):776–82.
Allaix ME, Arezzo A, Cassoni P, Famiglietti F, Morino M. Recurrence after transanal endoscopic microsurgery for large rectal adenomas. Surg Endosc. 2012;26:2594–600.
Morino M, Risio M, Bach S, Beets-Tan R, Bujko K, Panis Y, Quirke P, Rembacken B, Rullier E, Saito Y, Young-Fadok T, Allaix ME. Early rectal cancer: the European Association for Endoscopic Surgery (EAES) clinical consensus conference. Surg Endosc. 2015;29(4):755–73.
Morino M, Allaix ME, Famiglietti F, Caldart M, Arezzo A. Does peritoneal perforation affect short- and long-term outcomes after transanal endoscopic microsurgery? Surg Endosc. 2013;27(1):181–8.
Arezzo A, Arolfo S, Allaix ME, Munoz F, Cassoni P, Monagheddu C, Ricardi U, Ciccone G, Morino M. Results of Neoadjuvant Short-Course Radiation Therapy Followed by Transanal Endoscopic Microsurgery for T1-T2 N0 Extraperitoneal Rectal Cancer. Int J Radiat Oncol Biol Phys. 2015;92(2):299–306. pii: S0360-3016(15)00097-8. doi:10.1016/j.ijrobp.2015.01.024. [Epub ahead of print].
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Morino, M., Allaix, M.E. (2017). Transanal Endoscopic Microsurgery. In: Bonjer, H. (eds) Surgical Principles of Minimally Invasive Procedures. Springer, Cham. https://doi.org/10.1007/978-3-319-43196-3_33
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DOI: https://doi.org/10.1007/978-3-319-43196-3_33
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