Transanal Endoscopic Microsurgery: Principles and Techniques

Cancer of the rectum continues to be a significant health problem in industrialized co- tries around the world. Relative 5-year survival rates in the USA for cancer of the rectum from 1995 to 2001 improved to 65%, a 15% improvement over 20 years (American Cancer Society, 2007). The reasons for this dramatic improvement include more accurate pr- perative staging, aggressive neoadjuvant therapy and improved surgical technique as well as specialty-trained surgeons. Despite advances in nonoperative techniques of radiation therapy, chemotherapy and immunotherapy, surgical extirpation continues to be the cornerstone of curative treatment of this potentially lethal disease. Radical cancer excision with total mesorectal excision has become the preferred surgical procedure for even early-stage cancers of the rectum. Over the past decade the enthusiasm for local excision (and other local treatments) has given way to persuasive (predominantly retrospective) evidence that the incidence of locoregional recurrence due to unsuspected lymphatic metastases and positive lateral margins is un- ceptably high even for stage T tumors. Vigorous attempts to find characteristics of the 1 tumor that would allow successful local treatments are ongoing.

Transanal Endoscopic Microsurgery: Principles and Techniques is the first book to present a complete review of an exciting developing technology. Cancer of the rectum remains a significant health problem, despite the increasing improvement of survival rates. The improvement in patient care comes from many sources: more accurate preoperative staging, aggressive neoadjuvant therapy and improved surgical techniques. Surgical extirpation continues to be the cornerstone of curative treatment of this potentially lethal disease. Transanal endoscopic microsurgery (TEM) is a technique for the performance of local excision by way of a binocular magnified operating system. Comparative trials demonstrate significantly better oncologic results for rectal cancer treated by TEM compared to conventional local excision. TEM provides a technically superior method for excision of rectal polyps and select early rectal cancers, with lower costs and fewer complications when compared to conventional approaches.

The editors and chapter authors of Transanal Endoscopic Microsurgery: Principles and Techniques are the world’s leading experts on TEM and their collective clinical experience is reflected in the practically oriented approach in every chapter. The text will prove to be an asset to any colorectal or general surgeon’s library.