Is partial thickness excision in TAMIS without defect suture safe for benign rectal lesions?

Area of Science:

• Colorectal Surgery
• Minimally Invasive Procedures
• Surgical Oncology

Background:

• Transanal minimally invasive surgery (TAMIS) is a minimally invasive technique for rectal polypoid lesions.
• TAMIS is used for both benign and early-stage malignant (T1-T2) rectal lesions.
• Suturing defects after TAMIS can prolong operative time; this study explores resection without closure.

Purpose of the Study:

• To evaluate the efficacy and safety of TAMIS with partial thickness resection without suturing rectal lesions.
• To assess the feasibility of leaving mucosal defects open after TAMIS for benign rectal lesions.

Main Methods:

• Retrospective study of 10 patients with benign rectal masses treated with TAMIS.
• Exclusion criteria included suspected muscularis propria invasion or lymph node positivity.
• All lesions were resected via TAMIS, and mucosal defects were intentionally left unsutured.

Main Results:

• Ten patients (6 male, 4 female) with rectal lesions (mean distance 8.5 cm, size 1-4 cm) underwent TAMIS without defect closure.
• Histopathology revealed villous adenomas, adenocarcinomas (Tis, T1), and a neuroendocrine tumor.
• No early or late complications (bleeding, perforation, incontinence) were observed; all patients were discharged the next day.

Conclusions:

• Partial thickness resection of rectal benign lesions using TAMIS without defect closure is safe and feasible.
• This technique offers a viable alternative to suturing, potentially reducing operative time and patient morbidity.
• No recurrence was noted during follow-up evaluations.