Objective   To investigate the curative effect of retroflex endoscopic mucosal resection (REMR) for large-sized laterally spreading tumors in the super-low rectum and the applications

complications

and techniques of this procedure.   Methods   A total of 17 patients with tumor size more than 3.0 cm and tumors located less than 2.0 cm to the anus were included in this study. REMR was performed by means of en bloc or piecemeal snare cut method. A follow-up period for 3-24 months was conducted to evaluate the curative effect. The rates of complications and following treatments were recorded. All resected specimens were retrieved for pathological study.   Results   REMR was performed in 18 patients. Tumors in 16 patients were completely removed after one-time or multiple REMR procedures with satisfactory anal function retained in 16 patients. The curative rate was 88.8%. There were no remnants or recurrence of tumors during the follow-up period. One patient underwent Mile’s operation because of invasive cancer after REMR confirmed pathologically and another patient also underwent Mile’s operation due to tumor residual after REMR. Complications included 20 ml of average bleeding and 160 ml of maximum bleeding. No blood transfusion was employed in all patients. No perforation nor other complications occurred after REMR procedures.   Conclusion   REMR is a safe and minimally invasive therapy for the treatment of super-low rectal tumors due to its radical resection of the majority of low rectal benign tumors and satisfactory retained anus function.