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Transanal endoscopic microsurgery – a case report

Transanal endoscopic microsurgery is currently a method of choice for adenomas located up to 20 cm from the anal verge, which cannot be removed using endoscopy. We present a case of a 67-year-old patient with rectal tumour, which was initially diagnosed as a neoplastic lesion with low-grade dysplasia and was treated using this method. We emphasise that this type of management is also advisable in the absence of the possibility of obtaining a histopathological result corresponding to the clinical features of the lesion. The tumour was located low in the distal rectum, reaching the sphincters on the posterior wall. The tumour had a diameter of 2 x 3.5 cm. Diagnostic imaging showed features suggestive of a neoplastic lesion. A complete resection of the tumour was performed using a surgical rectoscope. The wound was closed with a continuous, braided, absorbable suture. Hospital stay was 5 days. The resected specimen was diagnosed as G1 adenocarcinoma. A follow-up 4 weeks after the surgery showed a healed wound, with no signs of incontinence. Continence was assessed using the Wexner Continence Scale. After oncological consultation, the patient was qualified for adjuvant radiation therapy. Transanal endoscopic microsurgery (TEM) proved to be a safe and effective method in the presented case of rectal tumour with low-grade dysplasia.