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A Strict Patient Selection Protocol Could Be the Key to Success for Transanal Minimally Invasive Surgery (TAMIS)

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This study investigated the feasibility of transanal minimally invasive surgery (TAMIS), as well as its excision quality, its oncologic outcomes, and its impact on anorectal function. Patients who underwent TAMIS… Click to show full abstract

This study investigated the feasibility of transanal minimally invasive surgery (TAMIS), as well as its excision quality, its oncologic outcomes, and its impact on anorectal function. Patients who underwent TAMIS at a single colorectal unit of a tertiary university hospital for benign rectal lesions or earlystage malignant rectal lesions, along with unsuitable patients for radical interventions, were included. TAMIS seemed to be a feasible technique with adequate oncologic outcomes and high excision quality, which preserved patients ’ quality of life. Abstract Objectives In recent years, the local excision of benign rectal lesions or early-stage rectal cancers using minimally invasive surgical techniques has replaced radical interventions that caused impairment in patients’ quality of life. The aim of the present study was to investigate the feasibility of transanal minimally invasive surgery (TAMIS), as well as its excision quality, its oncologic outcomes, and its impact on anorectal function. Methods Patients who underwent TAMIS at a single colorectal unit of a tertiary university hospital from 2015 until 2020 for benign rectal lesions or early-stage malignant rectal lesions, along with unsuitable patients for radical interventions, were included in the present study. Results Twenty-five patients underwent TAMIS for rectal lesions. Their median distance from the anal verge was 7 cm (range 4–12 cm) and their median size was 3.8 cm (range 2–6 cm). The median operative duration was 75 minutes (range 30–150 minutes) and the median hospitalization interval was 2 days (range 1–6 days). In addition, the negative resection rate was 100% and the recurrence rate was 4% during an average follow-up period of 30 months (range 3–36 months). Two patients (8%) presented short-term complications, and in 1 patient (4%) a hybrid technique was required. Seventeen patients (68%) reported moderate incontinence symptoms 6 weeks postoperatively that subsided in all patients 3 months postoperatively. Conclusions TAMIS seemed to be a feasible technique with adequate oncologic outcomes and high excision quality, which preserved patients’ quality of life. The impact of TAMIS on anorectal function after neoadjuvant chemoradiotherapy for rectal cancer should be further investigated, however.

Keywords: surgery tamis; transanal minimally; rectal lesions; invasive surgery; minimally invasive

Journal Title: Southern Medical Journal
Year Published: 2023

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