The rectum is one of the last stops in our digestive system. The rectum is responsible for storing feces before visiting the toilet.
Rectal malignancy, which is sometimes detected by colonoscopy, can be treated in various surgical ways. One of the innovative ways to treat it is to remove the tumor through the anus - Transanal Endoscopic Microsurgery (TEM).
When can a rectal tumor be excised through the anus?
Not all tumors can be treated with anus access. Most often, TEM is used for polyps or tumors which are located up to about 15 cm above the anus.
The size of the polyp or tumor is also important in determining the fit of this procedure, as the surgeon must make sure that all the tumor tissue has been completely removed during the operation.
The course of the surgery
TEM tumor removal uses an endoscopic approach, similar to that performed on a colonoscopy. A flexible camera is inserted through the anus without the need for an external incision.
Once the tumor or polyp is well identified, they are completely removed with the help of appropriate flexible surgical tools. The removed tissue is biopsied and sent for laboratory examination (pathology). If it is a large polyp, the remaining tissue is sutured to help it heal.
The procedure is usually performed under general anesthesia and lasts about an hour.
Preparation before surgery
To determine suitability for TEM tumor removal a surgical evaluation should be performed as well as additional imaging if necessary. Prior to surgery, intestinal preparation should be performed using bowel emptying preparations as directed by the medical staff.
You will also be evaluated by a doctor or anesthesiologist.
Recovery after TEM tumor resection
Since surgery is performed with an endoscopic approach, recovery from TEM is usually shorter and easier compared to surgeries which involve opening the abdomen. The hospitalization time is also shortened and can last only 24 hours.
You can return to a complete diet and routine gradually, according to doctor's instructions. You may be asked to return for surgical and / or oncological follow-up, depending on the results of the pathology from the surgery.
In general, endoscopic tumor removal helps maintain a better quality of life compared to removal through the open abdomen approach.
Possible complications
An endoscopic approach reduces the rate of postoperative complications. Possible complications include bleeding or infection in the area where the tumor was removed, intestinal obstruction and damage to the sphincters.
One of the disadvantages of the endoscopic approach is the inability to remove adjacent lymph nodes in case of malignant disease. Removal of lymph nodes is especially important for defining the stage of malignant disease. In the absence of a connective tissue sample, tumor removal may be partial and require reoperation or further oncological follow-up.
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