Al-Dhaheri M, Al-Ishaq F, Toffaha A, Nada MA, Parvaiz A, Kurer M. Transanal minimally invasive surgery for benign and malignant rectal lesions: midterm outcomes from a tertiary center.
Ann Saudi Med 2023;
43:348-351. [PMID:
38071443 PMCID:
PMC11182431 DOI:
10.5144/0256-4947.2023.348]
[Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/05/2023] [Accepted: 10/03/2023] [Indexed: 12/18/2023] Open
Abstract
BACKGROUND
Although transanal minimally invasive surgery (TAMIS) for rectal neoplasia has gained wide acceptance, the mid-term and long-term outcomes are not widely reported in the literature.
OBJECTIVE
Describe the mid-term outcomes of patients who underwent TAMIS for benign and malignant rectal lesions in a single center.
DESIGN
Retrospective cohort study.
SETTINGS
Tertiary referral center.
PATIENTS AND METHODS
Demographic, clinical, and oncological outcomes of patients who underwent TAMIS between January 2015 and December 2022 were prospectively collected. The indication for TAMIS was based on the National Comprehensive Cancer Network guidelines. The follow up for the cancer patients included clinical examination, tumor markers every 6 months and MRI rectum at the end of one year. In addition, colonoscopy and CT scan at years one and three and a final CT scan and colonoscopy at year five.
MAIN OUTCOME MEASURES
Mid-term oncological and clinical outcome.
RESULTS
Thirty elective TAMIS procedures included adenocarcinoma for 33.3% (n=10) of the patients, 20% (n=6) neuroendocrine tumor and the 40% (n=12) were adenomatous lesions. Negative resection margins were achieved in all malignant lesions. Perioperative complications occurred in 2 patients (6.6%), one patient had breaching into the peritoneal cavity, and postoperative hypotension occurred in another patient. The median follow-up time was 23 months (range: 5-72 months). Two patients with adenoma and positive margins developed recurrent adenoma (6.6%) and one patient with initial polypectomy biopsy of adenocarcinoma, had TAMIS with histopathology of adenoma and distant metastasis had developed.
CONCLUSIONS
TAMIS for local excision of rectal neoplasia is a valid option with favorable mid-term outcomes provided there is adherence to careful selection criteria.
LIMITATIONS
Retrospective nature and small number of the patients.
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