Completion proctectomy following transanal endoscopic microsurgery for early rectal cancer

Abstract

Transanal endoscopic microsurgery (TEM) has proven to be a safe and effective procedure in removal of rectal lesions and may be used in treatment of early rectal cancer in selected patients. In cases when the TEM specimen shows non-radical resection, or histological high-risk factors, completion proctectomy (CP) is warranted. It is debated when it is the best time to perform CP following TEM. It is furthermore uncertain whether CP leads to an increased risk of abdominoperineal excision. Herein, we review the available literature regarding controversial issues with early completion proctectomy following TEM.