Transanal endoscopic microsurgery (TEM) enables the surgeon to perform precise local excision of local rectal tumorous lesions. This technique requiring a specialized surgeon with extensive experience, was significantly simplified after the introduction of the harmonic scalpel.
In a group of 54 patients treated with this TEM technique between 2008 and 2013, 25 had rectal carcinoma. In 40% of these 25 patients, the final diagnosis was based on a histological examination of a resected specimen postsurgically.
Recurrent carcinomas were identified in three cases within one year. TEM is an accepted treatment modality of rectal carcinomas in elderly polymorbid high risk patients.
Local treatment of endosonographically and bioptically verified T1N0 carcinomas in patients who are able to undergo surgical resection treatment is still controversial.