Techniques of TEM for Behind-The-Fold Type Lesions in the Rectum and Sigmoid Colon

Abstract

For recent four years 46 patients were treated by TEM (transanal endoscopic microsurgery) for early rectal cancers and cancer-like lesions in our hospital. Most of the tumors which we resected were situated in the upper and the lower of the rectum (Ra and Rb) because of the technical difficulty of TEM in the rectosigmoid and sigmoid colon.
The risk for the perforation of rectal wall increases and the behind-the-fold type lesions were usual in the upper rectum. Therefore, the injecting the saline solution into the submucosa is effective for the mucosectomy by TEM and the other techniques for TEM are also useful such as cross-hand technique. By mastering these techniques, it is possible to select a less invasive method for surgical treatment of early rectal cancers and cancer-like lesions.