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.