AIM: Large (> 2 cm) rectal @entity652 are currently treated by transanal endoscopic microsurgery (TEM) or piecemeal endoscopic mucosal resection (EMR). The potential lower morbidity of EMR becomes irrelevant if it is less effective. We aimed to compare the safety and effectiveness of EMR and TEM for large rectal @entity652 . METHOD: Data from @entity1 undergoing TEM or EMR for a @entity652 >   2 cm in eight hospitals were retrospectively collected. @entity1 - and procedure-related characteristics, complications and recurrences were recorded. As EMR may require several attempts to achieve complete resection, early (after a single intervention) and late (permitting re-treatment for residual @entity652 within 6 months) recurrence rates were determined. RESULTS: Two hundred and ninety-two (292) @entity1 (49% male; mean age 67 years) were included; 219 were treated by TEM and 73 by EMR. @entity652 treated by EMR were smaller (median 30 vs 40 mm; P = 0.007). Perioperative complication rates were 2% for TEM and 6% for EMR (P = 0.171). @entity260 occurred in 24% of TEM @entity1 and in 13% of EMR @entity1 (P = 0.038). Median hospitalization after TEM was 3 days vs 0 days after EMR (P < 0.001). Median follow-up was 12.6 months (0-47 months); Early recurrence rates were 10.2% in TEM @entity1 and 31.0% in EMR @entity1 (P < 0.001); late recurrence rates were 9.6% and 13.8%, respectively (P = 0.386). CONCLUSION: After a single intervention, EMR of large rectal @entity652 seems less effective, but safer than TEM. When allowing re-treatment of residual @entity652 within 6 months, EMR and TEM seem equally effective. A prospective randomized comparison seems to be necessary.

Endoscopic mucosal resection vs transanal endoscopic microsurgery for the treatment of large rectal XXXX .

@entity1 :: ('9606', 'Species') :: ['patients', 'Patient'] @entity652 :: ('MESH:D000236', 'Disease') :: ['adenomas', 'rectal adenoma', 'adenoma', 'Adenomas'] @entity260 :: ('MESH:D011183', 'Disease') :: ['Postoperative complications']
@entity652 :: (MESH:D000236,Disease) :: ['adenomas']
