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Transanal Minimally Invasive Surgery Versus Endoscopic Submucosal Dissection for Rectal Lesions: A Community Hospital
Jau-Jie You1, Ming-Yin Shen1,2, William Tzu-Liang Chen1,3
1Department of Colorectal Surgery, China Medical University Hsinchu Hospital, Zhubei, Taiwan.
Summary
Transanal minimally invasive surgery (TAMIS) and endoscopic submucosal dissection (ESD) are safe for rectal polyps. TAMIS offers shorter operative times and no involved margins compared to ESD.
Area of Science:
- Colorectal surgery
- Minimally invasive procedures
- Gastroenterology
Background:
- Large or malignant rectal adenomatous polyps pose surgical challenges.
- Transanal minimally invasive surgery (TAMIS) and endoscopic submucosal dissection (ESD) are emerging techniques for rectal polyp resection.
Purpose of the Study:
- To compare tumor margins and surgical outcomes between TAMIS and ESD for large or malignant rectal adenomatous polyps.
Main Methods:
- Single institution retrospective analysis of 30 patients undergoing TAMIS (n=19) or ESD (n=11).
- Comparison of tumor characteristics, specimen size, operative time, and follow-up outcomes.
Main Results:
- No significant differences in tumor circumference, malignancy ratios, or specimen size.
- TAMIS had no involved resection margins compared to two in ESD (P=0.041).
- Median operative time was significantly shorter for TAMIS (72 min) versus ESD (120 min) (P=0.005).
Conclusions:
- Both TAMIS and ESD are feasible and safe in community hospital practice for rectal polyps.
- TAMIS demonstrated an advantage with shorter operative times and no involved margins.
