目的 探讨经肛门内镜显微手术（TEM）在直肠肿瘤手术中的应用价值。方法 分析总结山东大学附属千佛山医院2006 年5 月至2007 年5 月间内收治的42 例TEM 病人，其中31 例良性肿瘤11 例恶性肿瘤。结果 42 例TEM ，其中41 例获得了肿瘤的完整切除，1 例不完整切除直肠腺瘤（T0 期）31 例有1 例复发,复发率3.2%，直肠癌10 例中复发1 例，复发率10%；随访过程中无死亡病例。结论 TEM 是一项值得推广的安全、有效的微创外科技术, TEM 可以被用于良性直肠肿瘤和早期直肠癌的彻底切除。

Transanal endoscopic microsurgery for rectal tumors: diagnostic challenges, indications and short term results in 42 consecutive patients LIU Bo, XIA Li-jian, YANG Ming-yu, et al. Department of Gastrointestinal Surgery, Subsidiary Qianfoshan Hospital of Shandong University,Jinan250031,China Correspond author: XIA Li-jian, E-mail: xiaalbert@163.com Abstract Objective To study the application value of transanal endoscopic microsurgery (TEM) in the surgery of rectal cancer. Methods Between May 2006 and May 2007, TEM was performed in 42 patients at Subsidiary Qianfoshan Hospital of Shandong University. The histologic diagnosis was adenoma in 31 and adenocarcinoma in 11 patients. Results Clear resection margins were achieved in 41 of 42 patients (97.6%). During the follow-up, benign tumor recurrence was detected in 1 patients (3.2%). The recurrence rates among patients with malignant tumors were 9.8%. Conclusion Transanal endoscopic microsurgery is a safe and feasible technique with low incomplete excision rates and may be the preferred method in patients with benign rectal cancer. Its role in the management of malignant tumors should be limited to selected patients with T1 lesions.