Transanal Minimally Invasive Surgery for Benign and Malignant Rectal Lesions: Operative and Oncological Outcomes of a Single Center Experience

Gal Westrich, Moris Venturero, Gal Schtrechman, David Hazzan, Marat Khaikin, Aviram Nissan, Ron Shapiro, Lior Segev

Research output: Contribution to journalArticlepeer-review

Abstract

Background: Since introduced in 2010, the transanal minimally invasive surgery (TAMIS) has been gaining popularity worldwide for local excision of benign and early-stage malignant rectal lesions of the proximal and mid-rectum. The aim of this study was to review our experience with the procedure, including mid-term oncological outcomes. Materials and Methods: This is a retrospective descriptive study. The data collected include all patients who underwent TAMIS procedure in a single tertiary institute. Results: Forty TAMIS procedures were performed on 38 patients, 78% men and 22% women, with a median age of 67 years. The indications were 24 benign lesions, 14 adenocarcinoma, and 1 neuroendocrine tumor. The average lesion size was 43.2 mm and the average distance from the anal verge was 8 cm (range 5-12). We had no intraoperative complications and overall the 30-day morbidity rate was 20%, of which only one was major complication. No perioperative mortality was encountered. After a mean follow-up time of 26 months we had 3 cases of local recurrence (21.4%) of which 2 cases had high-risk features on the primary TAMIS pathology and refused our advice for completion proctectomy. Hence, they were both treated eventually with adjuvant radiotherapy. The distant recurrence rate was 14.2%. Conclusions: The TAMIS procedure is an acceptable option for local excision of rectal lesions for carefully selected patients. It has overt benefits of lower morbidity and easier recovery compared with radical surgery. When it is utilized for early-stage rectal cancers, high-risk pathological features should prompt a completion proctectomy.

Original languageEnglish
Pages (from-to)1122-1127
Number of pages6
JournalJournal of Laparoendoscopic and Advanced Surgical Techniques - Part A
Volume29
Issue number9
DOIs
StatePublished - Sep 2019

Keywords

  • local excision
  • rectal carcinoma
  • surgical technology
  • TAMIS

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