To investigate outcomes of the full-thickness excision in the treatment of rectal adenoma and early-stage carcinoma above peritoneal reflection by transanal endoscopic microsurgery(TEM).

The clinical data of 26 cases who suffered from rectal adenoma and early-stage carcinoma above peritoneal reflection with TEM full-thickness resections were retrospectively analyzed.

All of the operations was successfully completed, one of which was combined with laparoscopy surgery for suturing wound, and there was no operation related death in the 26 cases.Operation time was 70~150 min, and the time of hospitalization was 5~7 d. There was no intestinal leakage after operation, 2 cases occurred a small amount of blood in the stool after operation and 1 case suffered abdominal infection which was cured by antibiotics.Postoperative pathology showed differences from the preoperative clinical assessment.All 26 cases(including 2 cases of pT2 patients with an additional operation of laparoscopic Dixon surgery)were followed up.The follow-up time ranged from 6 to 72 months.During the follow-up time, we found that one case that postoperative pathology confirmed pT1 stage with lymph node involved the primary tumor site developed recurrence 6 months after operation, the rest were recurrence free(including two patients with pT2 stage added to radicalsurgery).

TEM full-thickness resection in treatment of rectal adenoma and early-stage carcinoma above peritoneal reflection is safe, and provides more detailed pathological information, and more to comply with en bloc resection of tumor radical principle, and is worth of the clinical promotion.