Rectal neuroendocrine tumours (rNETs) are increasingly detected and often amenable to organ-preserving local therapy. Rigid transanal platforms (TEM/TEO/TAMIS) offer en bloc, full-thickness excision with precise margin control; however, contemporary evidence is limited. We report our single-centre outcomes and contextualise them with a focused, PRISMA-guided systematic review. We retrospectively analysed a prospectively maintained database of consecutive rNETs treated with TEM/TEO (1993–2025). The primary endpoint was R0 resection; secondary endpoints included complications, length of stay, residual tumour at completion excision, and oncologic outcomes. In parallel, we systematically searched PubMed/MEDLINE and Embase (last update August 1st 2025) for studies reporting outcomes of rigid transanal excision for rNETs (TEM/TEO/TAMIS/robotic TAMIS). Purely endoscopic series, radical resections, and case reports ( 10 years). Rigid transanal excision achieves high-quality local control with low morbidity and provides reliable full-thickness clearance after incomplete endoscopic resection. The combined presentation of our institutional series with a focused review clarifies where TEM/TEO/TAMIS most benefits rNET care—particularly for completion surgery and intermediate-risk lesions—within contemporary guideline frameworks.
Arezzo et al. (Fri,) studied this question.