Benign rectal strictures managed with transanal resection - A novel application for transanal endoscopic microsurgery

Abstract

Objective: Six cases of management of rectal strictures by transanal endoscopic microsurgery (TEM) are described. Method: Patients are placed in the lithotomy - Trendelenburg position and the stricture is resected from 4-8 o'clock through the entire thickness of the fibrosis. The upper resection edge is mobilized including all layers of the rectal wall and the defect is sutured along the circumference. Results: Satisfactory anatomical and functional long-term results were obtained in 5 of 6 patients. Conclusion: TEM resection of benign strictures is feasible in some patients and should be tested in a randomized study against known procedures. © 2010 The Authors. Journal Compilation © 2010 The Association of Coloproctology of Great Britain and Ireland.