Treatment of rectal adenoma - Retrospective study on inpatients (1987-1991)

In carrying out an evaluation prior to acquisition of equipment for transanal endoscopic microsurgery (TEM), we wished to examine current concepts in the treatment of rectal adenoma, i.e.: What form of surgery was chosen in relation to the dimension and localization of the adenoma? Should the indications for the particular procedure be changed to render it less invasive? Should the new endoscopic surgical method TEM be introduced. 134 inpatients covering a 5-year period were evaluated. We analyzed the correlation between localization of the adenoma in the rectum (43% low, 22% middle, 36% high position), diameter of the tumor (37% < 2 cm, 38% 2-4 cm, 11% 4-6 cm, 10% > 6 cm) and type of surgery (endoscopic 27%, transanal 45%, anterior resection 25%). We found a high percentage of anterior resections in the middle rectum which could be reduced by introduction of the less invasive TEM.'S (22%) of our patients could have bren treated with TEM.