Transanal minimally invasive surgery: initial experience and short-term functional results

Area of Science:

• Colorectal Surgery
• Minimally Invasive Procedures
• Surgical Outcomes

Background:

• Transanal endoscopic microsurgery (TEMS) is the standard for rectal polyp excision.
• Transanal minimally invasive surgery (TAMIS) offers a less expensive, accessible alternative.
• Limited data exists on TAMIS's impact on fecal continence.

Purpose of the Study:

• To prospectively evaluate the functional outcomes of TAMIS.
• To assess changes in fecal continence using the Fecal Incontinence Severity Index (FIIS) pre- and post-operatively.

Main Methods:

• Prospective cohort study at a large teaching hospital.
• 37 patients underwent TAMIS between October 2011 and September 2013.
• Preoperative and postoperative Fecal Incontinence Severity Index scores were measured.

Main Results:

• Short-term morbidity was 14%; 16% had positive resection margins.
• Overall Fecal Incontinence Severity Index scores significantly improved post-TAMIS (p=0.02).
• 88% of patients with preoperative incontinence showed improvement; 3 patients with normal preoperative continence experienced a decrease.

Conclusions:

• Short-term functional results of TAMIS for rectal polyps are excellent and comparable to TEMS.
• TAMIS demonstrates significant improvement in anorectal function for patients with impaired preoperative continence.
• Further research is recommended to assess long-term morbidity and oncologic clearance.