Transanal Excision: Development, Technique, and Evidence

  • Laurel Blair
  • Dominique McKeever
  • John H. Marks


Local excision is growing in popularity as an alternative to radical resection with less morbidity. Though originally indicated for benign disease, its use has been expanded for malignancy in recent years. Patients with favorable disease or comorbidities that preclude them from a more radical surgery are ideal candidates for local excision. Local excision can be successfully coupled with neoadjuvant therapy to achieve favorable oncologic results in the treatment of early rectal cancers. In this chapter, we will discuss the outcomes associated with local excision, and more specifically, we will describe the technique of transanal endoscopic microsurgery (TEM). Since the advent of TEM in 1983, the treatment options for colorectal disease have greatly expanded and this technique continues to provide opportunities for advancement in this field.


Rectal Cancer Local Excision Local Recurrence Rate Transanal Endoscopic Microsurgery Natural Orifice Translumenal Endoscopic Surgery 
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Copyright information

© Springer Science+Business Media New York 2014

Authors and Affiliations

  • Laurel Blair
    • 1
  • Dominique McKeever
    • 1
  • John H. Marks
    • 1
    • 2
    • 3
    • 4
    • 5
  1. 1.Division of Colorectal SurgeryMain Line Health SystemsWynnewoodUSA
  2. 2.Lankenau Medical CenterWynnewoodUSA
  3. 3.Lankenau Institute of Medical ResearchWynnewoodUSA
  4. 4.Department of General Surgery and Digestive OncologyUniversity Nice Sophia-Antipolis, Centre Hospitalier UniversityNiceFrance
  5. 5.Marks Colorectal Surgical AssociatesWynnewoodUSA

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