A Strict Patient Selection Protocol Could Be the Key to Success for Transanal Minimally Invasive Surgery (TAMIS)

Area of Science:

• Colorectal surgery
• Minimally invasive surgery
• Oncology

Background:

• Minimally invasive surgical techniques are increasingly preferred for benign rectal lesions and early-stage rectal cancers.
• Radical interventions can negatively impact patients' quality of life.

Purpose of the Study:

• To evaluate the feasibility of transanal minimally invasive surgery (TAMIS).
• To assess TAMIS's excision quality, oncologic outcomes, and impact on anorectal function.

Main Methods:

• Retrospective study of 25 patients undergoing TAMIS for rectal lesions (benign or early-stage malignant) from 2015-2020.
• Analysis of operative duration, hospitalization, resection margins, recurrence rates, complications, and anorectal function.

Main Results:

• Median lesion distance: 7 cm; median size: 3.8 cm.
• Median operative time: 75 minutes; median hospitalization: 2 days.
• 100% negative resection rate, 4% recurrence rate over 30 months median follow-up.
• 8% short-term complications; 68% experienced temporary incontinence resolving by 3 months.

Conclusions:

• TAMIS is a feasible technique with adequate oncologic outcomes and high excision quality.
• TAMIS appears to preserve patients' quality of life.
• Further investigation is needed on TAMIS's impact on anorectal function after neoadjuvant chemoradiotherapy for rectal cancer.