TEM Surgery

Hello, I am scheduled for TEM Surgery. Could anyone advise me what to expect immediately after surgery and the recovery process.  I've heard of clips coming out??

Any tips that might help me?  Thank you

  • Hi Loubie18,

     I had TEMs surgery on February 20th, and found the recovery pretty good. I was up and about and felt ok the day of surgery, and wasn’t in any pain, I declined the IV pain medication I was offered, and managed well on paracetamol and ibuprofen. They insisted that I spend the night in intensive care, which even the staff there felt was unnecessary, as I wasn’t bleeding or at all unwell. I was in hospital for 2 nights and home the evening of day 3, mostly because they wanted to keep me on IV antibiotics for as long as possible. When I got home, I felt fine just very tired and weak, then a few days after surgery, when my stools became firm, it was very painful to open my bowels, and for half an hour or so afterwards. I was given some prescription pain killers and laxative, which helped somewhat. That pain carried on for about a week, and I also developed sciatica from the epidural they give you. Walking as much as I felt strong enough for helped, and I got some physiotherapy, which really helped. I had a small bleed for 3 days a week after the surgery, this was alarming as I hadn’t bled at all until then and wasn’t expecting it, but my surgeon assured me it was normal and nothing to worry about. 10 days after surgery, I felt back to normal besides some back pain. Though it was a bit longer before I could do 2 of my favourite things, pick up my toddler and eat spicy food!

    My histology results came back clear of cancer, but I’m now having a course of chemo radiotherapy anyway. In hindsight, I had been led to think that if the histology results were clear, my risks were very low and I wouldn’t need any more treatment, but in fact there was still a 25% chance that there was some residual cancer which is too small to detect. I wasn’t informed of this before the surgery, and therefore ended up feeling like I’d made an uninformed decision to have it. My only regret is not speaking to the oncologist before I decided to have the surgery, I only spoke to the surgeon. I probably would still have had it, but with full knowledge of the bigger picture. Everyone’s situation and risks are different, but I’d advise you to speak to an oncologist if you haven’t already. 

    I hope that’s helpful. I’m happy to try to answer any specific questions you have. All the best,

    C

  • Hello scaredofthis101  Thank you so much for your response. Your last paragraph has certainly got me thinking.  My local hospital and MDT referred me to a second hospital who do the TEM procedure. I'm told it's small but may be invasive so I had the endorectal ultrasound to investigate as it doesn't show on the MRI

    I had a phone call on my way home to book the TEM surgery. I havent spoken to anyone about the results. Their MDT meet Thursday's so I hoped I may get a call today.

    Plans are a general anaesthetic, stay overnight.  I am on warfarin so a lot of worries about bleeding and bridging medication.

    The surgeon mentioned 96% success rate of removing cancer, nothing has been said about chemo afterwards is this now standard procedure?

    Many thanks x 

  • Hi Loubie18,

    Sorry for the late reply, I have a toddler and struggle to find spare time with my treatment! I think that your risks aren’t necessarily the same as mine, it’s very specific to the size and shape of the tumour, the margins of healthy tissue, and depth the disease may have spread into the tissue underneath. This is what I know now, but no one explained it earlier in the treatment. Apparently my polyp was sessile (flat) which increased my risk slightly, this was known all along, but I wasn’t informed that it increased my risk until after my surgery. Has your tumour been classified yet? They may not be able to classify it until after the surgery. Mine is a T1 SM3, which is the most advanced stage 1, so my risks would have been lower if it was SM1 or 2. 

    Even now, my surgeon advised me to go on wait and watch (which I’m on anyway) and not have the treatment unless any cancer was actually found. The oncologist however advised that if I did this, and cancer was found in the future, she couldn’t guarantee that it would be dealt with using chemo / radiotherapy, it could mean major surgery, which I’m my case would mean a permanent colostomy, not an outcome I can accept. The surgeon also still quotes studies to me that show an 85-95% chance of getting rid of the cancer without treatment, where as the oncologist quotes only a 75% chance. It seems the data is not very good, so my decision was to err on the side of caution. It comes at a high price though, the radiation will make me completely infertile, not to mention I feel like crap!

    it’s all very personal both in terms of risks and what is an acceptable outcome to you. My advice is just to get all the facts as early as you can before making any irreversible decisions, as it took me months after diagnosis to learn the above. For me, speaking to my oncologist has been the most helpful in this regard. 

    Do you have a date for your surgery?

    Wishing you the very best. 

    C

  • Hi C,  thanks for taking the time to answer me I really do appreciate it.  Mine is flat too 8mm in size. Initially I was told T1/2  but the surgeon is now saying T1.

    My surgery is tomorrow morning!  Home enema early and at the hospital for 7am

    I have no idea of SM in fact it has not been mentioned if I recall.  

    I'm unsure how if you didn't have cancer that there is still cancer treatment given like radiotherapy and if this is a standard procedure other than the watch and wait as I don't want to be put to one side when action could be taken. You're right information really is the key to this.  Would you recommend asking the surgeon to put you in touch with the oncologist or is there another way?  

    I hope that you're working towards ending your treatment soon x

    Thank you for sharing

    Louise x 

  • Oh wow, tomorrow! Glad I finally got around to replying to you in time lol!

    There will be at least one oncologist on the MDT which has been discussing you, who will be familiar with your case. Your surgeon can easily arrange a referral or just a chat with them. 

    Good luck for tomorrow! You’ll be fine, it’s really not too bad, in a couple of days it will be behind you and you’ll be in the mend!

    All the best,

    C