Submucosal dissection has advantages over full-thickness transanal endoscopic microsurgery in selected rectal lesions

Abstract

Background: To establish the incidence of unsuspected malignancy in lesions excised through transanal endoscopic microsurgery (TEM) and examine the justification for full-thickness excision of all lesions thought to be benign pre-operatively. Methods: Demographic, operative and pathology data of all patients undergoing TEM at a single institution were collected in a prospectively maintained database. Follow-up data were collected with a focus on polyp recurrence rates and outcome in patients found to harbour malignancy. For lesions thought to be benign pre-operatively, a submucosal excision was routinely performed. Results: TEM was attempted in 156 cases between June 1999 and April 2013. Mea..