Complications of transanal endoscopic surgery

Over the past decade, transanal endoscopic surgery (TES) has gained worldwide popularity for its role in the excision of benign and favorable malignant rectal lesions. Compared to the traditional transanal excision, TES provides better visualization, less specimen fragmentation, and improved outcomes based on negative margin status and decreased recurrence rates. Although TES has significantly less morbidity and mortality than radical surgery, complications can occur in up to 5-25% of cases. Based on an extensive examination of the literature, this comprehensive review will outline the most common encountered complications during the intraoperative, early postoperative, and late postoperative period as well as provide management strategies and treatment recommendations to assist the surgeon should these complications be encountered. It is imperative that the surgeon has an in-depth understanding of the complications that can arise during TES and have the necessary tools to deal with those complications to ensure a safe and successful outcome for the patient.