Treatment of Rectal Adenomas by Transanal Endoscopic Microsurgery: 15 Years' Experience

Overview

Journal Surg Endosc

Publisher Springer

Specialties Gastroenterology
General Surgery
Radiology

Date 2009 Jul 1

PMID 19565297

Citations 35

Authors

Mario Guerrieri

Maddalena Baldarelli

Angelo De Sanctis

Roberto Campagnacci

Massimiliano Rimini

Emanuele Lezoche

Affiliations

Soon will be listed here.

Abstract

Background: The authors present their experience with rectal adenomas managed by transanal endoscopic microsurgery (TEM). The goals of this study were to examine our institution's experience by evaluating surgical morbidity, mortality, and local recurrence rate.

Methods: This retrospective study investigated 402 patients who underwent TEM a for preoperative diagnosis of adenoma from January 1993 to October 2008. The mean age was 65 years (range = 22-92 years). All patients were regularly followed up to determine treatment efficacy in terms of local recurrence rate.

Results: No 30-day perioperative mortality occurred. No conversion to laparoscopic or open procedures was reported. Minor complications occurred in 28 (7%) patients, whereas major complications were found only in 2 (0.5%) patients. Definitive histology confirmed adenomas in 366 cases (91%). At a mean follow-up of 84 months (range = 1-190 months), 16 (4%) adenomas recurred and were successfully retreated by TEM [14 cases (87.5%)] and by conventional surgery [2 patients (12.5%)]. No further recurrences were observed at subsequent follow-up.

Conclusion: The findings warrant the conclusion that TEM is a safe, effective treatment for rectal adenomas where endoscopic removal is not applicable and has low morbidity and no mortality.

Citing Articles

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Local full-thickness excision for sessile adenoma and cT1-2 rectal cancer: long-term oncological outcome.

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Learning Transanal Total Mesorectal Excision.

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