Prospective study of the functional results of transanal endoscopic microsurgery

Background/Aims: Most clinical research addresses the technological advances and oncological out comes of transanal endoscopic microsurgery. Our aim was to examine the functional results. Methodology: From August 1999 to November, 2000, 22 Taiwanese patients (14 men, 8 women; median age, 68 years) undergoing transanal endoscopic microsurgery, were prospectively examined. Functional questionnaires and anorectal manometry 1 were assessed before surgery and at 2 weeks, 6 weeks, 3 months, and 1 year. Results: The median distance from the anal verge to the tumor was 10cm. The median tumor diameter was 2.0cm. The median duration of surgery was 120 minutes. No surgical mortality or morbidity and no local recurrence occurred during a median follow-up of 23 months. The mean stool frequency and consistency were significantly better at 3 months after surgery than before surgery. The maximal testing pressure significantly decreased after surgery. The maximal contraction pressure and maximal tolerated volume Were significantly lower at 26 weeks. than before surgery; these values recovered at 1 year. Conclusions: Transanal endoscopic microsurgery is safe for the cure of benign tumors and the palliative excision of malignant tumors in middle and upper rectum. Anorectal function was preserved and improved, though some anorectal in metric parameters changed over time.