Background: We used video-assisted gasless transanal endoscopic microsurgery (TEM) to evaluate 12 consecutive patients for carcinoid tumor with pathologically typical features in the proximal rectum. The study parameters included feasibility, results and final outcome.
Methods: A scope with an optical angle of 25 and a 7-mm diameter was used for TEM. The carcinoid tumor was resected in full thickness. Primary closure was accomplished using a running suture of 3-0 braided absorbable suture.
Results: The tumor in these patients was <15 mm in diameter. It was localized within the submucosal layer on the oral side from the peritoneal reflection and unreachable via Park's transanal approach. The mean duration of the operation was 63 min. The postoperative course in all patients was free from significant complications, and all patients were discharged within 1 week. None of the patients had postoperative pain or required sedatives.
Conclusion: Video-assisted gasless TEM is a simple and minimally invasive procedure to treat benign carcinoid tumors in the proximal rectum.