Lezoche E, Guerrieri M, Paganini A, Feliciotti F, Di Pietrantonj F
Cattedra di Chirurgia Generale I, Istituto di Scienze Chirurgiche, Universita di Ancona, Ancona, Italy.
Surg Endosc. 1996 Jul;10(7):736-41. doi: 10.1007/BF00193047.
In 1983 G. Buess, in Germany, developed transanal endoscopic microsurgery (TEM), a new minimally invasive technique for the treatment of rectal tumors.
Rectal lesions are excised through a modified rectoscope of 40 mm in diameter under stereoscopic control in the gas-dilated rectal cavity. Full-thickness excision, partial-wall excision, or mucosectomy can be performed. Seventy-one patients were treated with the TEM technique in our department. Major complications were observed in one patient (1.4%). No mortality was reported.
Histological examination revealed 40 (56.3%) villous adenomas, 6 (8.4%) pT1; 17 (23.9%) pT2; 5 (7%) pT3 carcinomas; and 3 ((4.2%) other lesions. The recurrence rate was 2.8% for adenomas and 2.8% for carcinomas. The overall survival at mean follow-up of 17 months was 96.4%.
The advantages of TEM are less or no postoperative pain, unrestricted mobility, short hospitalization, quick rehabilitation, and absence of skin scars.
1983年，德国的G. 布斯研发了经肛门内镜显微手术（TEM），这是一种治疗直肠肿瘤的新型微创技术。
在气体扩张的直肠腔内，通过直径40毫米的改良直肠镜在立体控制下切除直肠病变。可进行全层切除、部分壁层切除或黏膜切除术。我科71例患者接受了TEM技术治疗。1例患者（1.4%）出现严重并发症。无死亡病例报告。
组织学检查显示，有40例（56.3%）绒毛状腺瘤、6例（8.4%）pT1期；17例（23.9%）pT2期；5例（7%）pT3期癌；以及3例（4.2%）其他病变。腺瘤的复发率为2.8%，癌的复发率为2.8%。平均随访17个月时的总生存率为96.4%。
TEM的优点是术后疼痛减轻或无疼痛、活动不受限、住院时间短、康复快且无皮肤瘢痕。
