Aim Comparison of transanal excision (TE) and transanal endoscopic microsurgery (TEM) of rectal adenomas (RA) has rarely been performed. Method From 1990 to 2007, the results of TE (43 RA) and TEM (216 RA) were compared. Rectal adenomas were matched for diameter and distance from the anal verge. Results Operation time was 47.5min for TE and 35min for TEM (P<0.001). Morbidity was 10% after TE and 5.3% after TEM (P<0.001). Negative resection margins were observed in 50% after TE and 88% after TEM (P<0.001). Fragmentation of the excised specimen was observed in 23.8% after TE and 1.4% after TEM (P<0.001). In cases of fragmentation, positive resection margins were observed more frequently. Recurrence was 28.7% after TE and 6.1% after TEM (P<0.001). After TE, RA with a negative resection margin had a local recurrence rate of 0%, compared with 59.6% with a positive margin (P<0.001), and after TEM these rates were 3.2 and 7.7% (P=0.3), respectively. Conclusion Transanal endoscopic microsurgery is superior to transanal excision of RA. © 2011 The Authors. Colorectal Disease

Adenoma, Local excision, Transanal endoscopic microsurgery, Transanal excision,
Colorectal Disease
Erasmus MC: University Medical Center Rotterdam

de Graaf, E.J.R, Burger, J.W.A, van Ijsseldijk, A.L.A, Tetteroo, G, Dawson, I, & Hop, W.C.J. (2011). Transanal endoscopic microsurgery is superior to transanal excision of rectal adenomas. Colorectal Disease, 13(7), 762–767. doi:10.1111/j.1463-1318.2010.02269.x