Abstract

BARRERAS GONZALEZ, Javier Ernesto et al. Cuban experience and the future perspectives of transanal endoscopic microsurgery. Rev Cubana Cir [online]. 2009, vol.48, n.4. ISSN 0034-7493.

INTRODUCTION: The aim of present study was to assess the indication and the results of transanal endoscopic microsurgery (TEM) for treatment of rectal benign and malign tumors in National Center of Minimal Access Surgery in Havana city. METHODS: A comprehensive review of literature was made on present managing of rectal benign and malign tumors by TEM and results of such technique were assessed during 4 years in National Center of Minimal Access Surgery. RESULTS: During study period 33 patients were operated on by this technique. Main indications of TEM were the presence of adenomas (72,8%). Mean surgical time was of 189,1 minutes; in 4 patients ( 12,1%) transoperative transfusion was used, and hospital stay was of 2,5 days. Main transoperative complications were the rectovaginal fistula, bleeding and dehiscence. Follow-up of patients fluctuates between 1 and 54 months (mean 28,3) with 4 local relapses in adenoma group. CONCLUSIONS: TEM is a safe and effective method for treatment of rectal benign and malign tumors (in early stages). It is the choice technique for the big rectal adenomas and rectum cancer with pT1 stages located in all the ampulla of rectum. It has all advantages of the minimal access surgery; relapse results are similar to that of abdominal surgery without complications of urinary or sexual dysfunction and that of fecal incontinence are minimal.

Keywords : Transanal endoscopic microsurgery; TEM; rectal cancer; rectal adenoma.

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