Benign rectal strictures managed with transanal resection--a novel application for transanal endoscopic microsurgery.

OBJECTIVE

Six cases of management of rectal strictures by transanal endoscopic microsurgery (TEM) are described.

METHOD

Patients are placed in the lithotomy - Trendelenburg position and the stricture is resected from 4-8 o'clock through the entire thickness of the fibrosis. The upper resection edge is mobilized including all layers of the rectal wall and the defect is sutured along the circumference.

RESULTS

Satisfactory anatomical and functional long-term results were obtained in 5 of 6 patients.

CONCLUSION

TEM resection of benign strictures is feasible in some patients and should be tested in a randomized study against known procedures.