Transanal minimally invasive surgery for benign and malignant rectal neoplasia

McLemore, Elisabeth C.; Weston, Lynn A.; Coker, Alisa M.; Jacobsen, Garth R.; Talamini, Mark A.; Horgan, Santiago; Ramamoorthy, Sonia

doi:10.1016/j.amjsurg.2014.01.006

Cited by 71 publications

(63 citation statements)

References 30 publications

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“…Likewise, urinary retention occurs more often when the lesion is more circumferential. 4 Our technique is adequate, with a total TAMIS completion rate of 100% for lesions that averaged 7 cm from the anal verge, a positive margin rate of only 8% (4 of 50), morbidity rate of 16% and an average LOS of 1.1 day. Our outcomes were comparable or better than those of other published series in recent years [7][8][9][10]17,18,[20][21][22] (Table 4).…”

Section: Discussionmentioning

confidence: 99%

“…These benefits have been widely reported in the literature. 4,5,13,14 Compared with TAE, TAMIS allows for better exposure and visualization of lesions along the entire length of the rectum. Contrary to previous indications for TAMIS, we found that excision of high rectal lesions were feasible with this technique; albeit slightly more challenging to perform, the surgery was less invasive and required shorter LOS.…”

Section: Discussionmentioning

confidence: 99%

“…It is disposable and requires fewer pieces of equipment to achieve the same or even better exposure than TEM. 4 Also, setup for TAMIS is easier and more manoeuvrable than TEM. 10,11 The TAMIS platform allows regular laparoscopic instruments to be used.…”

mentioning

confidence: 99%

“…3 The equipment carries substantial cost to a centre. 4 These factors limit TEM from being widely adopted. Hence, any oncological and functional benefit therein is not widely available.…”

mentioning

confidence: 99%

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Transanal minimally invasive surgery for benign large rectal polyps and early malignant rectal cancers: experience and outcomes from the first Canadian centre to adopt the technique

Caycedo‐Marulanda

Jiang

Kohtakangas

2017

CJS

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Background: Transanal minimally invasive surgery (TAMIS) has emerged as a relatively new technique in treating early cancer and benign lesion of the rectum. The technique is likely to be widely adopted, surpassing other comparable techniques owing to its simple setup and costeffectiveness. We assessed the outcomes of TAMIS at our centre. Methods:We retrospectively reviewed prospectively collected data on 50 patients who underwent TAMIS for benign, malignant T1 or T2 cancers that were unfit for radical surgery over a 4-year period. Outcomes, including 30-day complications and recurrence, as well as our ability to implement and integrate this technique at our centre were assessed.Results: All 50 TAMIS procedures were successful. The average lesion was 7 cm from the anal verge, the average tumour size was 2.5 cm, the average duration of surgery was 73 minutes, the average length of stay was 1.1 days, and the margin negativity was 84%. Major indications in our series included 25 lesions that were too large for endoscopic resection, 14 early cancers or high-grade dysplasia, 10 margin checks postpolypectomy, 6 cases of recurrent polyposis, and 4 medically unfit patients. There were no deaths. The rate of short-term complications, including rectal bleeding, reoperation and urinary retention, was 16%. The rate of long-term complications, including anal incontinence and stenosis, was 4%. Benign and malignant recurrence rates were 2% and 6%, respectively. Overall long-term requirement for invasive procedures, low anterior resection or abdominoperineal resection, was 12%. Conclusion:To our knowledge, this is the first Canadian study showing TAMIS to be an efficient and safe procedure for the treatment of well-selected patients with rectal lesions. Outcomes from our centre are comparable with those found in the literature.Contexte : La chirurgie transanale mini-invasive (TAMIS) s'est imposée comme une technique relativement nouvelle pour le traitement du cancer précoce et des lésions bénignes du rectum. La technique est en voie d'être adoptée à grande échelle, voire de supplanter d'autres techniques comparables, en raison de sa mise en place facile et de sa rentabilité. Nous avons évalué les résultats de la technique TAMIS dans notre centre.Méthodes : Nous avons fait une analyse rétrospective de données recueillies de façon prospective sur 50 patients traités par TAMIS pour cause de cancer T1 ou T2 malin ou bénin et non candidats à la chirurgie radicale, sur une période de 4 ans. Nous avons évalué les résultats, y compris les complications et la récidive sur 30 jours, ainsi que notre capacité d'adopter et d'intégrer cette technique dans notre centre. Résultats :Les 50 chirurgies TAMIS furent une réussite. La taille moyenne de la lésion était de 7 cm à partir de la marge anale, la taille moyenne de la tumeur était de 2,5 cm, la durée moyenne de la chirurgie était de 73 minutes, la durée moyenne d'hospitalisation était de 1,1 jour et le taux de marges négatives était de 84 %. Parmi les principales indications dans notre série...

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

mentioning

confidence: 99%

“…3 The equipment carries substantial cost to a centre. 4 These factors limit TEM from being widely adopted. Hence, any oncological and functional benefit therein is not widely available.…”

mentioning

confidence: 99%

See 2 more Smart Citations

Transanal minimally invasive surgery for benign large rectal polyps and early malignant rectal cancers: experience and outcomes from the first Canadian centre to adopt the technique

Caycedo‐Marulanda

Jiang

Kohtakangas

2017

CJS

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“…The prone jack-knife position can be considered for anterior based lesions, although the disadvantage of having to reposition the patient in the case of peritoneal entry has to be considered. [53][54][55][56] Candy cane or Allen stirrups may be used based on their availability. If there is any question that abdominal access may be required such as anticipated peritoneal entry for anterior proximal lesions, Allen stirrups are preferred so that the legs may be repositioned for the abdominal portion of the procedure.…”

Section: A Surgical Preparationmentioning

confidence: 99%

Transanal Minimally Invasive Surgery (TAMIS): a clinical spotlight review

2017

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Teresa deBeche-Adams, Imran Hassan, and the SAGES Guidelines Committee PreambleThe following clinical spotlight review regarding Transanal Minimally Invasive Surgery (TAMIS) is intended for physicians who manage and treat rectal pathology. It is meant to critically review this technique and the available evidence supporting its safety and efficacy. Based on the level of evidence, recommendations may or may not be given for its use in clinical practice. DisclaimerGuidelines for clinical practice and spotlight reviews are intended to indicate preferable approaches to medical problems as established by experts in the field. These recommendations will be based on existing data or a consensus of expert opinion when little or no data are available. Spotlight reviews are applicable to all physicians who address the clinical problem(s) without regard to specialty training or interests, and are intended to convey recommendations based on a focused topic; within the defined scope of the review, they indicate the preferable, but not necessarily the only acceptable approaches due to the complexity of the healthcare environment. Guidelines and recommendations are intended to be flexible. Given the wide range of specifics in any healthcare problem, the surgeon must always choose the course best suited to the individual patient and the variables in existence at the moment of decision. Guidelines, spotlight reviews, and recommendations are developed under the auspices of the Society of American Gastrointestinal Endoscopic Surgeons and its various committees, and approved by the Board of Governors. Each clinical spotlight review has been systematically researched, reviewed and revised by the guidelines committee, and, when appropriate, reviewed by an appropriate multidisciplinary team. The recommendations are therefore considered valid at the time of production based on the data available. Literature reviewA systematic literature search was performed using PubMed for Transanal Minimally Invasive Surgery (TAMIS). The literature was reviewed from September 1, 2010 through May 31, 2016. Both the quality of the evidence and the strength of the recommendation for each of the guidelines were assessed according to the GRADE system. This uses a 4-tiered system for denoting the quality of evidence (very low (+), low (+ +), moderate (+ + +), or high (+ + + +)) and a 2-tiered system for strength of recommendation (weak, or strong).

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