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The UK TEM database has collected data on over 500 cancers since 1993. This analysis examined the outcomes of those patients whoproceeded to rectal resection.Case note review was performed in 29 cases identified from the UK TEM database who underwent completion resection on the basis of unfavourable pathology.Surgery performed included anterior resection (n = 25), abdominoperineal resection (n = 3) and Hartmann's resection (n = 1). Resection was undertaken at a mean interval of 66.2 days (range 14-197). Mean length of stay after resection was 16.1 days (range 6 < 51). Residual cancer was found in 10/29 at the TEM site, 3/29 had no residual cancer but had lymph node involvement and 16/29 had no residual or metastatic disease. 5/29 patients had a permanent stoma, 19/29 a temporary stoma (84.2% reversal rate) and 5/29 patients avoided a stoma. No post operative mortality within 30 days, six have died of metastatic disease and to date, 20 have no evidence of recurrence.The study suggests that completion surgery after TEM has similar complications and stoma formation rates toprimary radical surgery supporting a role for TEM in the treatment strategy for rectal cancer.