Transanal endoscopic microsurgery (TEM)

In the period from July 1983 to June 1991, 321 operations were performed using the technique of transanal endoscopic microsurgery (TEM). The most proximal tumours resected were in the lower sigmoid up to 25cm from the anal verge. The complication rate requiring surgical intervention was 6.5% and the recurrence rate after polypectomy was 5%. Of 44 patients with pT1 low-risk tumours, one developed a recurrence as did two of the three patients with pT1 high-risk tumours. Using the technique of TEM, segmental resections with end-to-end anastomosis are possible in the extraperitoneal part of the rectum.