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Techniques in Coloproctology

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01-02-2019 | Minimally Invasive Surgery | Original Article

TAMIS is a valuable alternative to TEM for resection of intraluminal rectal tumors

Authors: F. Van den Eynde, J. Jaekers, S. Fieuws, A. M. D’Hoore, A. M. Wolthuis

Published in: Techniques in Coloproctology | Issue 2/2019

Abstract

Background

The aim of this study was to compare the short-term outcome after Transanal Endoscopic Microsurgery (TEM) and Transanal Minimally Invasive Surgery (TAMIS) for intraluminal rectal lesions.

Methods

Retrospective analysis of a prospectively maintained database of all TEM and TAMIS procedures performed at a single institution by one surgeon between March 2009 and September 2017 was conducted. Primary outcome was operating time. Secondary outcomes were blood loss, pathological outcome, length of hospital stay, 30-day readmission and mortality.

Results

Fifty-three patients underwent TEM procedure and 68 patients underwent TAMIS. Operating time was significantly shorter for TAMIS compared with TEM (median 45 vs 65 min, p < 0.0001). Blood loss was negligible for both TEM and TAMIS. Resection margins, lesion grade and invasion depth were comparable for both approaches. A significantly higher postoperative readmission rate was observed in the TEM group (17% vs 4.4%, p = 0.031). Mortality was zero in both groups.

Conclusions

TAMIS is a valuable alternative to TEM, leading to decreased operating times, because all resections can be done in lithotomy position.

Buess G, Kipfmuller K, Hack D, Grussner R, Heintz A, Junginger T (1988) Technique of transanal endoscopic microsurgery. Surg Endosc 2:71–75CrossRefPubMed

Buess G, Theiss R, Hutterer F, Pichlmaier H, Pelz C, Holfeld T et al (1983) Transanal endoscopic surgery of the rectum—testing a new method in animal experiments. Leber Magen Darm 13:73–77PubMed

Clancy C, Burke JP, Albert MR, O’Connell PR, Winter DC (2015) Transanal endoscopic microsurgery versus standard transanal excision for the removal of rectal neoplasms: a systematic review and meta-analysis. Dis Colon Rectum 58:254–261CrossRefPubMed

Atallah S, Albert M, Larach S (2010) Transanal minimally invasive surgery: a giant leap forward. Surg Endosc 24:2200–2205CrossRefPubMed

Marks JH, Frenkel JL, Greenleaf CE, D’Andrea AP (2014) Transanal endoscopic microsurgery with entrance into the peritoneal cavity: is it safe? Dis Colon Rectum 57:1176–1182CrossRefPubMed

Molina G, Bordeianou L, Shellito P, Sylla P (2016) Transanal endoscopic resection with peritoneal entry: a word of caution. Surg Endosc 30:1816–1825CrossRefPubMed

Barendse RM, Doornebosch PG, Bemelman WA, Fockens P, Dekker E, de Graaf EJ (2012) Transanal employment of single access ports is feasible for rectal surgery. Ann Surg 256:1030–1033CrossRefPubMed

Hayashi S, Takayama T, Yamagata M, Matsuda M, Masuda H (2013) Single-incision laparoscopic surgery used to perform transanal endoscopic microsurgery (SILSTEM) for T1 rectal cancer under spinal anesthesia: report of a case. Surg Today 43:325–328CrossRefPubMed

Hompes R, Ris F, Cunningham C, Mortensen NJ, Cahill RA (2012) Transanal glove port is a safe and cost-effective alternative for transanal endoscopic microsurgery. Br J Surg 99:1429–1435CrossRefPubMed

10.

Lim SB, Seo SI, Lee JL, Kwak JY, Jang TY, Kim CW et al (2012) Feasibility of transanal minimally invasive surgery for mid-rectal lesions. Surg Endosc 26:3127–3132CrossRefPubMed

11.

Lorenz C, Nimmesgern T, Back M, Langwieler TE (2010) Transanal single port microsurgery (TSPM) as a modified technique of transanal endoscopic microsurgery (TEM). Surg Innov 17:160–163CrossRefPubMed

12.

Ragupathi M, Haas EM (2011) Transanal endoscopic video-assisted excision: application of single-port access. JSLS 15:53–58CrossRefPubMedPubMedCentral

13.

Althumairi AA, Gearhart SL (2015) Local excision for early rectal cancer: transanal endoscopic microsurgery and beyond. J Gastrointest Oncol 6:296–306PubMedPubMedCentral

14.

Lee L, Edwards K, Hunter IA, Hartley JE, Atallah SB, Albert MR et al (2017) Quality of local excision for rectal neoplasms using transanal endoscopic microsurgery versus transanal minimally invasive surgery: a multi-institutional matched analysis. Dis Colon Rectum 60:928–935CrossRefPubMed

15.

Melin AA, Kalaskar S, Taylor L, Thompson JS, Ternent C, Langenfeld SJ (2016) Transanal endoscopic microsurgery and transanal minimally invasive surgery: is one technique superior? Am J Surg 212:1063–1067CrossRefPubMed

16.

Rimonda R, Arezzo A, Arolfo S, Salvai A, Morino M (2013) TransAnal Minimally Invasive Surgery (TAMIS) with SILS port versus Transanal Endoscopic Microsurgery (TEM): a comparative experimental study. Surg Endosc 27:3762–3768CrossRefPubMed

17.

de Buck van Overstraeten A, Mark-Christensen A, Wasmann KA, Bastiaenen VP, Buskens CJ, Wolthuis AM et al (2017) Transanal versus transabdominal minimally invasive (completion) proctectomy with ileal pouch-anal anastomosis in ulcerative colitis: a comparative study. Ann Surg 266:878–883CrossRef

18.

Wolthuis AM, Bislenghi G, de Buck van Overstraeten A, D’Hoore A (2015) Transanal total mesorectal excision: towards standardization of technique. World J Gastroenterol 21:12686–12695CrossRefPubMedPubMedCentral

19.

Wolthuis AM, Cini C, Penninckx F, D’Hoore A (2012) Transanal single port access to facilitate distal rectal mobilization in laparoscopic rectal sleeve resection with hand-sewn coloanal anastomosis. Tech Coloproctol 16:161–165CrossRefPubMed

20.

Wolthuis AM, de Buck van Overstraeten A, D’Hoore A (2014) Dynamic article: transanal rectal excision: a pilot study. Dis Colon Rectum 57:105–109CrossRefPubMed

21.

Mege D, Bridoux V, Maggiori L, Tuech JJ, Panis Y (2017) What is the best tool for transanal endoscopic microsurgery (TEM)? A case-matched study in 74 patients comparing a standard platform and a disposable material. Int J Colorect Dis 32:1041–1045CrossRef

22.

Barendse RM, Dijkgraaf MG, Rolf UR, Bijnen AB, Consten EC, Hoff C et al (2013) Colorectal surgeons’ learning curve of transanal endoscopic microsurgery. Surg Endosc 27:3591–3602CrossRefPubMed

23.

Helewa RM, Rajaee AN, Raiche I, Williams L, Paquin-Gobeil M, Boushey RP et al (2016) The implementation of a transanal endoscopic microsurgery programme: initial experience with surgical performance. Colorect Dis 18:1057–1062CrossRef

24.

Lee L, Kelly J, Nassif GJ, Keller D, Debeche-Adams TC, Mancuso PA et al (2018) Establishing the learning curve of transanal minimally invasive surgery for local excision of rectal neoplasms. Surg Endosc 32:1368–1376CrossRefPubMed

25.

Clermonts S, van Loon YT, Stijns J, Pottel H, Wasowicz DK, Zimmerman DDE (2018) The effect of proctoring on the learning curve of transanal minimally invasive surgery for local excision of rectal neoplasms. Techn Coloproctol 17:1–11

Title: TAMIS is a valuable alternative to TEM for resection of intraluminal rectal tumors
Authors: F. Van den Eynde
J. Jaekers
S. Fieuws
A. M. D’Hoore
A. M. Wolthuis
Publication date: 01-02-2019
Publisher: Springer International Publishing
Keyword: Minimally Invasive Surgery
Published in: Techniques in Coloproctology / Issue 2/2019
Print ISSN: 1123-6337
Electronic ISSN: 1128-045X
DOI: https://doi.org/10.1007/s10151-019-01954-7

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TAMIS is a valuable alternative to TEM for resection of intraluminal rectal tumors

Abstract

Background

Methods

Results

Conclusions

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Abstract

Background

Methods

Results

Conclusions

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