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Transanal Endoscopic Microsurgical Excision

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Anorectal and Colonic Diseases

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Abstract

Transanal endoscopic microsurgery (TEM) allows the minimally invasive local excision of rectal tumors located between 2–4 and 18 cm above the anal verge with the aid of a special operative rectoscope and a magnified view. This technique is not yet generally established because of the necessary special instrumentation and tools, unusual technical aspects of the approach, and stringent patient selection criteria (Fig. 15.1). Compared with conventional transanal resection, TEM provides superior exposure of tumors higher up in the rectum (i. e., up to 18 cm from the anal verge). The greater precision of resection, combined with low (relative to anterior resection) morbidity (5–10%) and short duration of hospitalization make this technique a reliable, and in some cases, more effective surgical approach than laparotomy or laparoscopy with low anterior resection, provided careful patient selection is performed.

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Authors and Affiliations

  1. Service de Chirurgie Viscérale, Centre Hospitalier Universitaire Vaudois, 1011, Lausanne, Switzerland

    Nicolas Demartines

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  1. Nicolas Demartines
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Editors and Affiliations

  1. Service de Chirurgie Viscérale, Centre Hospitalier Universitaire Vaudois, 1011, Lausanne, Switzerland

    Jean-Claude R. Givel

  2. Department of Colorectal Surgery, The John Radcliffe Hospital, OX3 9DU, Headington, Oxford, UK

    Neil Mortensen

  3. Responsable de l’Unité de Proctologie, Hôpital Cantonal Universitaire de Genève, Rue Gabrielle Perret-Gentil 4, 1211, Genève 14, Switzerland

    Bruno Roche

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Demartines, N. (2010). Transanal Endoscopic Microsurgical Excision. In: Givel, JC., Mortensen, N., Roche, B. (eds) Anorectal and Colonic Diseases. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-540-69419-9_15

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  • DOI: https://doi.org/10.1007/978-3-540-69419-9_15

  • Publisher Name: Springer, Berlin, Heidelberg

  • Print ISBN: 978-3-540-69418-2

  • Online ISBN: 978-3-540-69419-9

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