Introduction: Transanal endoscopic microsurgery (TEMS) is a minimally invasive alternative to total mesorectal excision (TME), the “gold standard” for colorectal cancer treatment. TEMS offers several advantages, including preservation of sphincter and rectal function, faster recovery with shorter hospital stays, and significantly lower morbidity/mortality compared to TME. These benefits are particularly important for older or frail patients, where minimizing surgical trauma and preserving organ function can enhance quality of life (QoL). This study investigates patient experiences and QoL outcomes in individuals with rectal cancer who underwent TEMS therapy.

Patients and Methods: The study evaluated 34 patients with stage T1/T2, N0, M0 rectal cancer who had undergone TEMS at least three years prior. QoL was assessed using the Short Form SF-12v2, Wexner Score (WxSC), and Sexual Function Questionnaire (SFQ). Patient experiences were evaluated using a specially designed questionnaire.

Results: The mean follow-up was 6.9 years. Patients rated their TEMS experience highly, with a mean score of 7.9 (SD=2.8) on a 0–10 scale. Ratings were positively associated with postoperative bowel function (p=0.026), preoperative information (p=0.047), and mental QoL (p=0.003). Postoperative pain was minimal, with a median score of 1 (IQR 0–5.5), and was correlated with family support (p=0.009). Most patients (84%-88.4%) reported receiving clear and adequate preoperative information. Physical QoL was lower than the general population mean, particularly among males, while mental QoL was comparable. Good or perfect continence was reported by 82.4% of patients, with a mean WxSC of 3.97 (SD=3.86). Sexual function scores showed no gender differences but were negatively affected by age. Mental QoL correlated with fewer sexual problems and higher satisfaction. Overall, 86.2% of patients were satisfied with TEMS, linked to lower WxSC scores.

Conclusion: TEMS is associated with favorable long-term QoL outcomes and high patient satisfaction, demonstrating its value as a minimally invasive treatment option.