Emphysema as a complication after transanal endoscopic microsurgery (TEM) (case report and review)

Abstract

Background: transanal endoscopic microsurgery (TEM) is a safe method of local excision of benign tumor and early cancer. Emphysema is rare complication after transanal procedures, occurring only in 1.5%. There is no accepted approach for these patients. AIM: definition and treatment options of ectopic air after TEM.Materials and Methods: the search was performed using PubMed and e-Library database with the following keywords: «transanal», «emphysema», «microsurgery», «pneumoperitoneum». Data about patients, symptoms, complications, treatment and results were extracted and systematized.Results: the clinical emphysema rate after TEM was 0,02%. The most frequent symptoms is crepitation in lower abdomen and fever. Increase in C-reactive protein level and leukocytosis — important markers. The method of choice for diagnosis is computed tomography. Management of emphysema symptoms is possible with conservative methods.Conclusion: the accumulation of experience in the treatment of emphysema after TEM will allow a unified approach of managing these patients.