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Serra-Aracil et al. Mini-invasive Surg 2019;3:37 Mini-invasive Surgery
DOI: 10.20517/2574-1225.2019.36

Original Article Open Access

Management of the main postoperative surgical
complications after transanal endoscopic

microsurgery: an observational study

Xavier Serra-Aracil, Laura Mora-López, Anna Pallisera-Lloveras, Sheila Serra-Pla, Albert Garcia-Nalda,
Esther Gil-Barrionuevo, Salvador Navarro-Soto

Colorectal Surgery Unit, Department of General and Digestive Surgery, Parc Taulí University Hospital, Universitat Autònoma de
Barcelona (UAB), Sabadell 08208, Barcelona, Spain.

Correspondence to: Dr. Xavier Serra-Aracil, Colorectal Surgery Unit, Department of General and Digestive Surgery, Parc Taulí
University Hospital, Universitat Autònoma de Barcelona (UAB), Parc Taulí s/n, Sabadell 08208, Barcelona, Spain.
E-mail: xserraa@gmail.com
How to cite this article: Serra-Aracil X, Mora-López L, Pallisera-Lloveras A, Serra-Pla S, Garcia-Nalda A, Gil-Barrionuevo E,
Navarro-Soto S. Management of the main postoperative surgical complications after transanal endoscopic microsurgery: an
observational study. Mini-invasive Surg 2019;3:37. http://dx.doi.org/10.20517/2574-1225.2019.36
Received: 13 Sep 2019 First Decision: 12 Nov 2019 Revised: 14 Nov 2019 Accepted: 3 Dec 2019 Published: 12 Dec 2019

Science Editor: Giulio Belli Copy Editor: Cai-Hong Wang Production Editor: Jing Yu

Abstract

Aim: Rates of clinically relevant postoperative morbidity after transanal endoscopic microsurgery (TEM) are low.
For this reason, there are few descriptions in the literature on the management of these complications. Because
of this lack of information, their importance may be either underestimated or overestimated (in the latter case,
leading to overtreatment). The present article reports the frequency of the occurrence of postoperative surgical
complications after TEM and describes various approaches to their management.

Methods: An observational study was carried out with prospective data collection and retrospective analysis from
June 2004 to June 2019, including all patients undergoing TEM for rectal tumors. All postoperative complications
were recorded using the Clavien-Dindo classification (Cl-D), as well as preoperative, surgical, postoperative, and
pathological variables.

Results: During the study period, 778 patients underwent TEM, of whom 716 met the inclusion criteria. Postoperative
morbidity was 22.1% (158/716). Clinically relevant morbidity (Cl-D > II) was 5% (36/716). The most frequent
complication was rectal bleeding, occurring in 115/716 (16.1%) patients; 85 of these 115 (73.9%) patients were
grade I Cl-D. Urinary complications were rare (30/716, 4.2%). Similarly, infectious complications of perianal and
pelvic abscesses appeared in 7/716 (1%) patients, two of whom required colostomy.

© The Author(s) 2019. Open Access This article is licensed under a Creative Commons Attribution 4.0
International License (https://creativecommons.org/licenses/by/4.0/), which permits unrestricted use,
sharing, adaptation, distribution and reproduction in any medium or format, for any purpose, even commercially, as long
as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license,
and indicate if changes were made.

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