{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,13]],"date-time":"2026-01-13T08:24:50Z","timestamp":1768292690069,"version":"3.49.0"},"reference-count":39,"publisher":"Wiley","issue":"9","license":[{"start":{"date-parts":[[2018,4,17]],"date-time":"2018-04-17T00:00:00Z","timestamp":1523923200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Colorectal Disease"],"published-print":{"date-parts":[[2018,9]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Aim<\/jats:title><jats:p>To determine the percentage of residual lesion observed in the pathology study of transanal endoscopic surgery (<jats:styled-content style=\"fixed-case\">TEM<\/jats:styled-content>) specimens after endoscopic polypectomy of malignant rectal polyps with questionable margins, and the need for further surgery. Secondary aims: to determine the morbidity and mortality associated with this procedure and to identify the percentage of recurrence after excision by <jats:styled-content style=\"fixed-case\">TEM<\/jats:styled-content>.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Observational study with prospective data collection of all patients undergoing <jats:styled-content style=\"fixed-case\">TEM<\/jats:styled-content> after endoscopic polypectomy for malignant rectal polyps or non\u2010invasive high\u2010grade neoplasia, from January 2004 to December 2016. An en bloc full\u2010thickness wall excision of the scar was performed. Variables recorded: histology of <jats:styled-content style=\"fixed-case\">TEM<\/jats:styled-content> specimen, 30\u2010day morbidity and mortality according to the Clavien\u2010Dindo classification, need for salvage surgery and recurrence.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Fifty out of 690 patients undergoing <jats:styled-content style=\"fixed-case\">TEM<\/jats:styled-content> during the study period (36 adenocarcinomas, five non\u2010invasive high\u2010grade neoplasias and 9 neuroendocrine tumors) were included. Post\u2010surgery histology showed residual lesion in 21 (42%) patients: 7 neuroendocrine tumors, 10 adenomas and 4 adenocarcinomas (two <jats:styled-content style=\"fixed-case\">pT<\/jats:styled-content>1, one <jats:styled-content style=\"fixed-case\">pT<\/jats:styled-content>2 and one <jats:styled-content style=\"fixed-case\">pT<\/jats:styled-content>3). The <jats:styled-content style=\"fixed-case\">pT<\/jats:styled-content>2 and <jats:styled-content style=\"fixed-case\">pT<\/jats:styled-content>3 patients (4%) underwent salvage surgery. No recurrence was observed, and mean follow\u2010up was 29.1\u00c2 \u00b1 21.6 months. The 30\u2010day morbidity rate was 14%, but 4\/7 with Clavien\u2010Dindo grade I.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>After endoscopic polypectomy of malignant rectal polyps with questionable margins, the presence of residual lesion in the pathology study of transanal resection specimens is high. <jats:styled-content style=\"fixed-case\">TEM<\/jats:styled-content> with full\u2010thickness resection of these lesions is an appropriate treatment, allowing disease control and achieving minimal morbidity<\/jats:p><\/jats:sec>","DOI":"10.1111\/codi.14108","type":"journal-article","created":{"date-parts":[[2018,3,26]],"date-time":"2018-03-26T01:52:58Z","timestamp":1522029178000},"page":"789-796","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":17,"title":["Transanal endoscopic surgery is effective and safe after endoscopic polypectomy of potentially malignant rectal polyps with questionable margins"],"prefix":"10.1111","volume":"20","author":[{"given":"X.","family":"Serra\u2010Aracil","sequence":"first","affiliation":[{"name":"Coloproctology Unit General and Digestive Surgery Department Parc Taul\u00ed University Hospital Universitat Aut\u00f2noma de Barcelona Sabadell Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6572-7356","authenticated-orcid":false,"given":"A.","family":"Pallisera\u2010Lloveras","sequence":"additional","affiliation":[{"name":"Coloproctology Unit General and Digestive Surgery Department Parc Taul\u00ed University Hospital Universitat Aut\u00f2noma de Barcelona Sabadell Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"L.","family":"Mora\u2010Lopez","sequence":"additional","affiliation":[{"name":"Coloproctology Unit General and Digestive Surgery Department Parc Taul\u00ed University Hospital Universitat Aut\u00f2noma de Barcelona Sabadell 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