直肠后方病变（RRLs）是起源于直肠后方空间组织的罕见病变。无论病变类型如何，全切除是标准治疗方法。传统手术方法（前、后、联合）已有较好的描述。经肛门内窥镜微创手术（TEM）是作为RRLs另一种替代手术方法的小创伤技术。本研究旨在评估通过TEM手术治疗RRLs的患者疗效以及手术后并发症和复发率。我们调查了2000至2020年期间在一家医疗中心接受TEM手术治疗的RRLs患者，与历史对照组进行后续结果比较。共有39名RRLs患者接受TEM治疗。其中，37个病变为良性，2个为恶性。病变中位大小（IQR）为20mm（15，32.5mm），病变距肛缘中位距离（IQR）为50mm（50，72.5mm），手术时间中位数（IQR）为48.5分钟（41.75，60分钟）。除一例外，所有病变均完全切除。中位住院时间（IQR）为1天（1天，1天）。3名患者出现术后并发症，其中两例经第二次手术后解决。采用TEM手术切除RRLs显示出卓越的总体效果，具有可接受的并发症和复发率，是一种可行的替代手术方法。© 2023 Springer Nature Switzerland AG。

Retrorectal lesions (RRLs) are rare lesions that originate from the tissue present in the retrorectal space. The gold standard of care is complete resection regardless of pathology. The traditional approaches (anterior, posterior, and combined) are relatively well described. Transanal Endoscopic Microsurgery (TEM) is a minimally invasive technique offered as an alternative approach for RRLs.To evaluate the outcomes of patients diagnosed with RRL and treated by the TEM approach, especially postoperative complications, and the recurrence rate.Patients with RRLs treated with the TEM technique in one medical center between 2000 and 2020 were identified. Their postoperative outcomes were compared with historical controls.Thirty-nine patients diagnosed with RRL were operated on using the TEM platform. Thirty-seven RRLs were benign, and two were malignant. Their median size (IQR) was 20 mm (15, 32.5). The median distance (IQR) from the anal verge was 50 mm (50, 72.5). The median operative time (IQR) was 48.5 min (41.75, 60). All, except one lesion, were completely resected. The median length of stay (IQR) was one day (1, 1 day). Postoperative complications were diagnosed in three patients, two of which resolved following a second operation.The implementation of TEM for the resection of RRLs demonstrated excellent overall results with acceptable complication and recurrence rate and represented a viable alternative surgical approach.© 2023. Springer Nature Switzerland AG.