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  • Title: TEM/local excision: indications, techniques, outcomes, and the future.
    Author: Saclarides TJ.
    Journal: J Surg Oncol; 2007 Dec 15; 96(8):644-50. PubMed ID: 18081069.
    Abstract:
    Transanal endoscopic microsurgery (TEM) has emerged as a safe method for excising virtually any rectal adenoma and carefully selected cancers. Extended applications include treatment of extra- and supra-sphincteric fistulae, rectovaginal fistulae, anastomotic strictures, and sinus tracts. The procedure utilizes an air-tight system, long shafted instruments, high-quality magnifying optics, and constant carbon dioxide insufflation, all of which facilitate a precise excision and closure with clear margins. Complications are few, most patients can be treated as an outpatient.
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