ABSTRACT
Transanal endoscopic microsurgery (TEM) utilizes a closed, airtight system that provides
constant rectal distension, improved visibility, and longer reach than conventional
instrumentation. Virtually any rectal adenoma and properly selected cancers can be
removed with this technique. It is safe, complications are few, and most patients
can be treated on an outpatient basis. Once TEM has been mastered, it may become the
technique of choice for locally excising rectal neoplasms. Complications are few;
however, they are not seen any less frequently than conventional local excision. Such
complications include bleeding, urinary retention, and temporary soilage just to name
a few. Regarding TEM excision of cancers, strict selection criteria must be satisfied.
TEM is best suited for TI cancers. TEM should not replace low anterior resection or
abdominoperineal resection for those cancers that have either deep penetration into
the rectal wall or lymph node metastases.
KEYWORDS
Transanal excision - rectal adenomas - cancers
