Endoscopic Transanal Microsurgery as a Treatment of Benign Rectal Tumors

Abstract

Introduction: Endoscopic transanal microsurgery is a minimally invasive procedure for local treatment of large adenomas and early-stage rectal cancers.

Objective: To assess the outcomes of endoscopic transanal microsurgery in patients with benign rectal tumors at the National Center for Minimal Access Surgery in Havana.

Methods: A retrospective study of a 15-year prospective database was carried out. A total of 91 patients with benign rectal tumors underwent endoscopic transanal microsurgery between April 2004 and December 2019. The following variables were included: age, sex, indication, surgical time, tumor location, tumor size, hospital stay, postoperative complications and local recurrence.

Results: The main indication was rectal adenoma, accounting for 70 (76.9%) patients. The mean age was 63.4 years, surgical time was 81.1 minutes and tumor size was 3.5 cm. Hospital stay was one day. Postoperative complications were four (4.3%): two bleedings, one suture dehiscence and one stenosis. Two patients (2.8%) had local recurrence in the adenoma group. No conversions to laparoscopic or open surgery were performed.

Conclusion: Endoscopic transanal microsurgery was a feasible and safe technique in the treatment of endoscopically unresectable rectal adenomas, adenomas with high-grade dysplasia and other rectal tumors.