대한대장항문학회

<b>Purpose:</b> Local treatment of rectal tumors have become an alternative to the classic radical operation. However, conventional transanal procedures are limited to tumors located in the lower rectum and the precision of the excision is<br>restricted by<br>the limitation of the surgeon's visualization during the procedure. This report will present our surgical management and functional results after TEM, a new minimally invasive technique for the treatment of rectal tumors. <b>Methods:</b> From<br>December<br>1994 to January 2000, 136 patients underwent TEM. All patients were evaluated preoperatively with sigmoidoscopy or colonoscopy with biopsy. The indications for TEM were benign rectal tumors and T1 and T2 malignant rectal tumors with well or<br>moderately<br>differentiation. All patients were followed up 1 month postoperatively and every 3 months thereafter. <b>Results:</b> The mean operation time was 56.5 minutes (25∼150 minutes) and the mean postoperative hospital stay was 3.6 days (2∼10 days).<br>On<br>the<br>basis of the postoperative evaluations, 56 of the 136 patients proved to have benign tumors while the remaining 80 patients had malignant tumors. One hundred thirty five patients were removed with adequate resection margins. One patient had<br>cancer<br>cell<br>involvement at the resection margin. There were no serious complications. After a mean observation time of 29 months (12∼42 months), there were five noted recurrences. Functional results were excellent; 24 of the 136 patients complained of<br>impaired<br>continence or defecation disorders in a review one month postoperatively. These problems improved during the first 6 months after the surgery. <b>Conclusions:</b> We feel that TEM is an adequate method for removal of benign rectal tumors, and<br>properly<br>selected early rectal cancers.<br>