Skip to main content

Advertisement

SpringerLink
Log in

What is the best tool for transanal endoscopic microsurgery (TEM)? A case-matched study in 74 patients comparing a standard platform and a disposable material

  • Short Communication
  • Published:
International Journal of Colorectal Disease Aims and scope Submit manuscript

Abstract

Purpose

Transanal endoscopic microsurgery (TEM) is the gold standard for local excision of rectal lesions, but no study exists concerning the best material. The objective was to compare TEM using a disposable material vs a standard platform through a case-matched study.

Methods

Patients who underwent TEM for rectal neoplasms were identified from prospective databases in two tertiary referral centers and matched according to four criteria (sex, tumor location, size, distance from the anal verge): TEM using a disposable material (GelPoint Applied®; group A) and TEM using a standard TEO® platform (Karl Storz, Tuttlingen, Germany; group B).

Results

A total of 74 patients were included and divided into group A (n = 33) and group B (n = 41). Full-thickness resection was less frequent in group A (85%) than B (100%; p = 0.01). Adenocarcinoma was less frequent in group A than B: 27 vs 42% (p = 0.03). No difference was noted regarding median operative time (53 vs 53 min; p = 0.6) and a peritoneal perforation rate (6 vs 20%; p = 0.17). Median length of stay was shorter in group A than B (4 vs 5 days; p < 0.008). No significant difference was noted for major morbidity (12 vs 10%; p = 0.66), R1 resection (21 vs 10%; p = 0.2), and recurrence rates (8 vs 7%; p = 0.62). No difference was noted for rectal stenosis (3 vs 12%; p = 0.22) and transit disorder rates (12 vs 17%; p = 0.74).

Conclusions

Our study suggested that TEM can be performed using either a TEO® platform or a disposable material, with similar surgical results. The TEO® platform seems to be superior to obtain full-thickness and R0 resection.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

References

  1. Christoforidis D, Cho H-M, Dixon MR et al (2009) Transanal endoscopic microsurgery versus conventional transanal excision for patients with early rectal cancer. Ann Surg 249(5):776–782

    Article  PubMed  Google Scholar 

  2. Peng J, Chen W, Sheng W et al (2011) Oncological outcome of T1 rectal cancer undergoing standard resection and local excision. Color Dis 13(2):e14–e19

    Article  CAS  Google Scholar 

  3. Buess G, Kipfmüller K, Hack D et al (1988) Technique of transanal endoscopic microsurgery. Surg Endosc 2(2):71–75

    Article  CAS  PubMed  Google Scholar 

  4. Atallah S, Albert M, Larach S (2010) Transanal minimally invasive surgery: a giant leap forward. Surg Endosc 24(9):2200–2205

    Article  PubMed  Google Scholar 

  5. Lim S-B, Seo S-I, Lee JL et al (2012) Feasibility of transanal minimally invasive surgery for mid-rectal lesions. Surg Endosc 26(11):3127–3132

    Article  PubMed  Google Scholar 

  6. Lorenz C, Nimmesgern T, Back M et al (2010) Transanal single port microsurgery (TSPM) as a modified technique of transanal endoscopic microsurgery (TEM). Surg Innov 17(2):160–163

    Article  PubMed  Google Scholar 

  7. Ragupathi M, Haas EM (2011) Transanal endoscopic video-assisted excision: application of single-port access. JSLS 15(1):53–58

    Article  PubMed  PubMed Central  Google Scholar 

  8. Hayashi S, Takayama T, Yamagata M et al (2013) Single-incision laparoscopic surgery used to perform transanal endoscopic microsurgery (SILSTEM) for T1 rectal cancer under spinal anesthesia: report of a case. Surg Today 43(3):325–328

    Article  PubMed  Google Scholar 

  9. Rimonda R, Arezzo A, Arolfo S et al (2013) Transanal minimally invasive surgery (TAMIS) with SILS™ port versus transanal endoscopic microsurgery (TEM): a comparative experimental study. Surg Endosc 27(10):3762–3768

    Article  PubMed  Google Scholar 

  10. Saget A, Maggiori L, Petrucciani N et al (2015) Is there a limit to transanal endoscopic surgery? A comparative study between standard and technically challenging indications among 168 consecutive patients. Color Dis 17(7):O155–O160

    Article  CAS  Google Scholar 

  11. Hompes R, Ris F, Cunningham C et al (2012) Transanal glove port is a safe and cost-effective alternative for transanal endoscopic microsurgery. Br J Surg 99(10):1429–1435

    Article  CAS  PubMed  Google Scholar 

  12. Barendse RM, Doornebosch PG, Bemelman WA et al (2012) Transanal employment of single access ports is feasible for rectal surgery. Ann Surg 256(6):1030–1033

    Article  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Digestive Surgery, Charles Nicolle Hospital, Rouen, France

    Diane Mege, Valérie Bridoux & Jean-Jacques Tuech

  2. Department of Colorectal Surgery, Beaujon Hospital, Assistance Publique-Hôpitaux de Paris, Université Paris VII, 100 Boulevard du Général Leclerc, 92110, Clichy, France

    Diane Mege, Léon Maggiori & Yves Panis

Authors
  1. Diane Mege
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Valérie Bridoux
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Léon Maggiori
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Jean-Jacques Tuech
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Yves Panis
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Yves Panis.

Ethics declarations

Sources of funding

None.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Mege, D., Bridoux, V., Maggiori, L. et al. What is the best tool for transanal endoscopic microsurgery (TEM)? A case-matched study in 74 patients comparing a standard platform and a disposable material. Int J Colorectal Dis 32, 1041–1045 (2017). https://doi.org/10.1007/s00384-016-2733-0

Download citation

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00384-016-2733-0

Keywords

Search

Navigation