Background: Due to the variety of methods for local ablation of sessile rectal polyps and low-risk T1 rectal cancer, a retrospective study by transanal local excision, the endoscopic microsurgery (TEM) was performed. The results of the TEM were compared with literature-based results of endoscopic submucosal dissection (ESD).
Materials and methods: 174 patients who had received a TEM during the period from March 2003 to October 2011 for a removal of a rectal polyp or low risk cancer were included in the study. The evaluation included the en bloc and R0 resection rate, duration of surgery, the postoperative hospitalisation, postoperative complications and recurrence rate.
Results: The en bloc-resection rate was 87.5 % (152 of 174) and the R0 resection was achieved in 84.5 % (147 of 174) of the cases. The average surgery duration was 33 (5-121) min, with an average specimen size of 4 (1.2-13) cm. The average postoperative length of stay included 5 (1-15) d. The postoperative complication rate was 3 % (4 of 174) and the recurrence rate was 4 % (7 of 174) with an average follow-up of 36 (6-108) months.
Conclusion: Compared to the Japanese results of ESD in the rectum based on literature results, we show equal or better results for the TEM. Compared to the European results of the ESD, the results of the TEM show advantages in terms of higher en bloc and R0 resection rates, shorter intervention times also with larger specimen sizes and a lower postoperative complication rate.
Georg Thieme Verlag KG Stuttgart · New York.