ArticleInternational journal of colorectal disease2016
Risk of complications and long-term functional alterations after local excision of rectal tumors with transanal endoscopic microsurgery (TEM).
Article in International journal of colorectal disease, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 24 papers, 5 of them syntheses that pooled it.
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Who cites it
24 citing papers in PubMed, 5 syntheses or guidelines pooled it.
- Risk of recurrence after local resection of T1 rectal cancer: a meta-analysis with meta-regression.Surgical endoscopy · 2022Pooled it
- Local recurrence after local excision of early rectal cancer: a meta-analysis of completion TME, adjuvant (chemo)radiation, or no additional treatment.The British journal of surgery · 2020Pooled it
- Should the rectal defect be sutured following TEMS/TAMIS carried out for neoplastic rectal lesions? A meta-analysis.Annals of the Royal College of Surgeons of England · 2020Pooled it
- Individual participant data pooled-analysis of risk factors for recurrence after neoadjuvant radiotherapy and transanal local excision of rectal cancer: the PARTTLE study.Techniques in coloproctology · 2019Pooled it
- Should the rectal defect be closed following transanal local excision of rectal tumors? A systematic review and meta-analysis.Techniques in coloproctology · 2017Pooled it
- Can weBMJ open · 2017Trial
- Consequences of omitting additional treatment after local excision of high-risk early rectal cancer: a national cohort.International journal of colorectal disease · 2026Article
- Rectal Neuroendocrine Tumors: Toward Translationally Informed Comparisons of ESD and TEM.Clinical and translational gastroenterology · 2025Article
- Completion Total Mesorectal Excision: A Case-Matched Comparison With Primary Resection.Annals of surgery open : perspectives of surgical history, education, and clinical approaches · 2023Article
- Short- and long-term outcomes in ypT2 rectal cancer patients after neoadjuvant therapy and local excision: a multicentre observational study.Techniques in coloproctology · 2023Observational
- Short- and long-term outcomes as well as anal function of transanal natural orifice specimen extraction surgery versus conventional laparoscopic surgery for sigmoid colon or rectal cancer resection: a retrospective study with over 5-year follow-up.Wideochirurgia i inne techniki maloinwazyjne = Videosurgery and other miniinvasive techniques · 2022Article
- Completion surgery vs. primary TME for early rectal cancer: a national study.International journal of colorectal disease · 2022Article
- Multidisciplinary management of elderly patients with rectal cancer: recommendations from the SICG (Italian Society of Geriatric Surgery), SIFIPAC (Italian Society of Surgical Pathophysiology), SICE (Italian Society of Endoscopic Surgery and new technologies), and the WSES (World Society of Emergency Surgery) International Consensus Project.World journal of emergency surgery : WJES · 2021Article
- Survival analysis of local excision vs total mesorectal excision for middle and low rectal cancer in pT1/pT2 stage and intermediate pathological risk.World journal of surgical oncology · 2019Article
- Morbidity after transanal endoscopic microsurgery: risk factors for postoperative complications and the design of a 1-day surgery program.Surgical endoscopy · 2019Observational
- Comparative Quality of Life in Patients Following Transanal Minimally Invasive Surgery and Healthy Control Subjects.Journal of gastrointestinal surgery : official journal of the Society for Surgery of the Alimentary Tract · 2018Article
- Fecal incontinence after transanal endoscopic microsurgery.International journal of colorectal disease · 2018Article
- MRI surveillance for the detection of local recurrence in rectal cancer after transanal endoscopic microsurgery.European radiology · 2017Article
- Transanal minimally invasive surgery for rectal polyps and selected malignant tumors: caution concerning intermediate-term functional results.International journal of colorectal disease · 2017Article
- Oncology Section EDGE Task Force on Urogenital Cancer: A Systematic Review of Clinical Measures for Incontinence.Rehabilitation oncology (American Physical Therapy Association. Oncology Section) · 2017Article
Corrections and comments
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Authors and funding
7 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
introductionTransanal endoscopic microsurgery (TEM) is a consolidated technique for the excision of rectal tumors. However, many aspects relating to its morbidity, risk of functional alterations, and therapeutic outcomes are still unclear. The aim of this study was to assess the rate of morbidity and fecal incontinence after TEM, and to identify associated risk factors.
methodsWe prospectively recorded the clinical data of 157 patients who underwent TEM from 1996 to 2013. Among these, 89 patients answered a questionnaire for the assessment of fecal continence at a median follow-up time of 40 months.
resultsIntraoperative and postoperative TEM complication rates were 3.8 and 20.4%. The mortality rate was 0.6%. A distance from the anal verge of more than 6 cm correlated with a higher risk of perforation, while patients with cancer were more likely to have postoperative bleeding. Incontinence was reported by 32 (36%) patients, of which 7 (8%) experienced transitory symptoms only, while 25 (28%) reported persistent symptoms. We found a correlation between patients receiving preoperative radiotherapy (RT) and the development of fecal incontinence. The recurrence rate was 3% (1/32) in pT1, 80% (4/5) in pT2, and 100% (1/1) in pT3. After radiotherapy, 7% (1/9) showed a good response (pT0-1), and 18% (2/7) showed no response (pT2-3).
conclusionsTEM is associated with low morbidity but the risk of developing functional alterations is not negligible and should be discussed with the patient before the operation. Good oncological outcomes are possible for early invasive cancers and for selected advanced cancers following a good response to preoperative RT.
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