**5.1 Benign adenomas**

The standard procedure for the management of benign adenomas with size and morphology that do not allow a complete endoscopic removal is now considered a full-thickness excision by TEM. In these patients, TEM may avoid the morbidity of major surgery with a low recurrence rate [2, 18].

Nowadays, however, with appropriately selected indications, endoscopic mucosal resection (EMR) or endoscopic submucosal dissection (ESD) can be suitable alternative to surgery for subinvasive rectal tumor. In case of R1 endoscopic removal at final pathology, a subsequent salvage endoluminal loco-regional resection by TEM can be obtained aimed at achieving R0 resection [19].
