Transanal minimally invasive surgery for rectal polyps and selected malignant tumors: caution concerning intermediate-term functional results

Clermonts, Stefan H. E. M.; Loon, Yu-Ting van; Schiphorst, A. H. W.; Wasowicz, Dareczka K.; Zimmerman, D. D. E.

doi:10.1007/s00384-017-2893-6

Cited by 18 publications

(9 citation statements)

References 41 publications

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“…Overall, TAMIS is very well tolerated [28,29,[45][46][47] . Studies published thus far have focused only on the conventional platform.…”

Section: Functional Outcomesmentioning

confidence: 99%

“…Mean FISI scores before and after surgery decreased from 10 to 5 (P = 0.01) at median follow-up of 11 months, consistent with an overall significant improvement in anorectal function following TAMIS. The same cohort was then evaluated again after a median follow-up of 3 years in 44 patients [45] . Mean preoperative FISI scores were 8.3 (range 0-35) vs. 5.4 (range 0-20) at one-year post-TAMIS (P = 0.5).…”

Section: Functional Outcomesmentioning

confidence: 99%

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Conventional and robotic transanal minimally invasive surgery for rectal neoplasia

Jahansouz¹,

Arsoniadis²,

Sands³

2021

Mini-invasive Surg

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The treatment of rectal cancer is evolving at a rapid pace in parallel with advancements in surgical technique. One such advancement is the application of the laparoscopic platform to the transanal approach, coined transanal minimally invasive surgery (TAMIS). TAMIS overcomes many of the shortcomings of the traditional transanal approach to the local resection of rectal neoplasia, offering greater visualization and access to the middle and upper rectum with improved oncologic outcomes. Following the introduction of conventional TAMIS, the robotic platform was introduced and applied in analogous fashion. Over the past decade, data have accumulated enabling the comparison of the two approaches most notably with regard to patient morbidity, mortality, and oncologic outcomes. This review discusses the most recently available outcomes regarding conventional and robotic TAMIS and provides a comparison of the two platforms in the treatment of rectal neoplasia. While randomized controlled trials comparing the two platforms are lacking, important differences have been identified. Conventional TAMIS is the more cost-effective approach while advancements in the robotic platform allow the surgeon to be seated and ergonomically optimized, allowing greater visualization and ease of suturing. Differences in oncologic outcomes between the two platforms have not been identified. Head-to-head randomized controlled trials are required to determine if any differences in functional or oncologic outcomes exist.

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“…Overall, TAMIS is very well tolerated [28,29,[45][46][47] . Studies published thus far have focused only on the conventional platform.…”

Section: Functional Outcomesmentioning

confidence: 99%

Section: Functional Outcomesmentioning

confidence: 99%

Conventional and robotic transanal minimally invasive surgery for rectal neoplasia

Jahansouz¹,

Arsoniadis²,

Sands³

2021

Mini-invasive Surg

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“…There are some concerns about the effect of dilatation of the anal canal on anal function when placing the device 22,23) . As compared with rigid anoscope like TEO/TEM, applying single port device into anus for local excision might be a comparable procedure for anal function 24,25) . However, its effect in patients who underwent TaTME, in which long-time application of transanal device is needed, has not yet been fully demonstrated and should be carefully evaluated 26) .…”

Section: Disadvantages and Specific Complications Of Tatmementioning

confidence: 99%

Transanal TME: new standard or fad?

Hasegawa

Yoshida

Morimoto

et al. 2019

J Anus Rectum Colon

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Transanal total mesorectal excision (taTME) has been developed to overcome the difficulty of laparoscopic dissection and transection in the deep pelvis. TaTME has several clinical benefits over laparoscopic surgery, such as better exposure of the distal rectum and direct determination of distal resection margin. Although evidence demonstrating the true benefits of taTME over laparoscopic TME (LapTME) is still insufficient, accumulating data have revealed that, as compared with LapTME, taTME is associated with shorter operative time and a lower conversion rate without jeopardizing other short-term outcomes. However, taTME is a technically demanding procedure with specific complications such as urethral injury, and so sufficient experience of LapTME and step-by-step acquisition of the skills needed for this procedure are requisite. The role of transanal endoscopic surgery is expected to change, along with the recent progress in the treatment of rectal cancer, such as robotic surgery and the watch-and-wait strategy. Optimization of treatment will be needed in the future in terms not only of oncological but also of functional outcomes.

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“…TAMIS combines single-incision laparoscopic surgery with more flexible transanal platforms, the learning curve is shorter and the purchase of expensive equipment can be avoided. In addition, TAMIS guarantees a good therapeutic effect in rectal polyps, rectal adenomas, early rectal cancer and other rectal mucosal lesions in the upper and middle rectum[ 8 , 9 ].…”

Section: Introductionmentioning

confidence: 99%

Transanal minimally invasive surgery vs endoscopic mucosal resection for rectal benign tumors and rectal carcinoids: A retrospective analysis

Shen¹,

Zhao²,

Tao³

et al. 2020

WJCC

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BACKGROUND Transanal minimally invasive surgery (TAMIS) is a good choice for resection of rectal neoplasms. Endoscopic mucosal resection (EMR) is also widely used in the treatment of benign rectal tumors such as rectal polyps and rectal adenomas. However, no studies have compared the outcome of TAMIS and EMR. AIM To compare the short-term outcomes after TAMIS and EMR for rectal carcinoid and benign tumors (including rectal polyps and adenomas). METHODS From January 2014 to January 2019, 44 patients who received TAMIS and 53 patients who received EMR at The Fifth People’s Hospital of Shanghai were selected. Primary outcomes (surgical-related) were operating time, blood loss, length of postoperative hospital stay, rate of resection margin involvement and lesion fragmentation rate. The secondary outcomes were complications such as hemorrhage, urinary retention, postoperative infection and reoperation. RESULTS No significant differences were observed in terms of blood loss (12.48 ± 8.00 mL for TAMIS vs 11.45 ± 7.82 mL for EMR, P = 0.527) and length of postoperative hospital stay (3.50 ± 1.87 d for TAMIS vs 2.72 ± 1.98 d for EMR, P = 0.065) between the two groups. Operating time was significantly shorter for EMR compared with TAMIS (21.19 ± 9.49 min vs 49.95 ± 15.28 min, P = 0.001). The lesion fragmentation rate in the EMR group was 22.6% (12/53) and was significantly higher than that (0%, 0/44) in the TAMIS group ( P = 0.001). TAMIS was associated with a higher urinary retention rate (13.6%, 6/44 vs 1.9%, 1/53 P = 0.026) and lower hemorrhage rate (0%, 0/44 vs 18.9%, 10/53 P = 0.002). A significantly higher reoperation rate was observed in the EMR group (9.4%, 5/53 vs 0%, 0/44 P = 0.036). CONCLUSION Compared with EMR, TAMIS can remove lesions more completely with effective hemostasis and lower postoperative hemorrhage and reoperation rates. TAMIS is a better choice for the treatment of rectal carcinoids.

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Transanal minimally invasive surgery for rectal polyps and selected malignant tumors: caution concerning intermediate-term functional results

Cited by 18 publications

References 41 publications

Conventional and robotic transanal minimally invasive surgery for rectal neoplasia

Conventional and robotic transanal minimally invasive surgery for rectal neoplasia

Transanal TME: new standard or fad?

Transanal minimally invasive surgery vs endoscopic mucosal resection for rectal benign tumors and rectal carcinoids: A retrospective analysis

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