Transanal endoscopic microsurgery

Best Pract Res Clin Gastroenterol. 2014 Feb;28(1):143-57. doi: 10.1016/j.bpg.2013.11.005. Epub 2013 Dec 4.

Abstract

Transanal endoscopic microsurgery (TEMS) is a well established method of accurate resection of specimens from the rectum under binocular vision. This review examines its role in the treatment of benign conditions of the rectum and the evidence to support its use and compliment existing endoscopic treatments. The evolution of TEMS in early rectal cancer and the concepts and outcomes of how it has been utilised to treat patients so far are presented. The bespoke nature of early rectal cancer treatment is changing the standard algorithms of rectal cancer care. The future of TEMS in the organ preserving treatment of early rectal cancer is discussed and how as clinicians we are able to select the correct patients for neoadjuvant or radical treatments accurately. The role of radiotherapy and outcomes from combination treatment using TEMS are presented with suggestions for areas of future research.

Keywords: Chemoradiotherapy; Early rectal cancer; Rectal adenoma; Short course radiotherapy; TEM; TEMS; Transanal endoscopic microsurgery.

Publication types

  • Review

MeSH terms

  • Anal Canal / surgery*
  • Chemoradiotherapy, Adjuvant
  • Early Detection of Cancer
  • Endoscopy, Digestive System*
  • Humans
  • Microsurgery / methods*
  • Neoadjuvant Therapy
  • Organ Sparing Treatments
  • Radiotherapy, Adjuvant
  • Rectal Neoplasms / pathology
  • Rectal Neoplasms / surgery*
  • Treatment Outcome