Middle East Experience With Transanal Endoscopic Microsurgery (TEM)

Document Type: Research/Original Article


1 Colorectal Research Center, Shiraz University of Medical Sciences, Shiraz, IR Iran

2 Department of Colorectal Surgery, Shiraz University of Medical Sciences, Shiraz, IR Iran

3 Department of Colorectal Surgery, Mashhad University of Medical Sciences, Mashhad, IR Iran


conditions. Big deal of this procedure is avoiding of open abdominal surgeries or better exposure in transanal approches.
Objectives: The purpose of this study was to present a single institutional experience in Shiraz, Iran regarding the application of Transanal Endoscopic Microsurgery (TEM). To our knowledge this is the first report from the Middle East.
Patients and Methods: Between 2009 and 2012, thirty patients underwent TEM in our center. We assessed complications and recurrence rate. Patients with fewer than six months of follow-up were excluded.
Results: Patients included 17 men and 13 women with a mean age of 44.4 years (ranged 17-80). The mean tumor distance from the anal verge was 9.8 cm. One patient with adenomatous polyp experienced recurrence 14 months postoperatively. Regarding procedure-related complications, one case developed hemorrhage and another case fever and infection in the site of operation. Two patients experienced incontinence for about 3 weeks after TEM surgery.
Conclusions: Considering the cultural and religious context of the Middle East, we recommend TEM procedure in specialized centers in this region of the world.