Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2022 Mar;26(3):175-180.
doi: 10.1007/s10151-021-02556-y. Epub 2021 Dec 14.

Implementation of transanal minimally invasive surgery (TAMIS) for rectal neoplasms: results from a single centre

W Lossius  1 , T Stornes  2 , T E Bernstein  2   3 , A Wibe  2   3
Affiliations

Implementation of transanal minimally invasive surgery (TAMIS) for rectal neoplasms: results from a single centre

W Lossius et al. Tech Coloproctol. 2022 Mar.

Abstract

Background: Local excisions are important in a tailored approach to treatment of rectal neoplasms. In cases of low risk T1 local excision facilitates rectal-preserving treatment. Transanal minimally invasive surgery (TAMIS) is the most recent alternative developed for local excision. In this study we evaluate the results after implementing TAMIS as the routine procedure for local excision of rectal neoplasms.

Methods: All patients who underwent TAMIS from January 2016 to January 2020 at St. Olav's University Hospital were included, and clinical, pathological and oncological data were prospectively registered. The primary endpoint was local recurrence, and the secondary endpoint was complications.

Results: There were 76 patients (42 men, mean age was 69 years [range 26-88 years]), The mean tumour level was 82 mm (range 20-140 mm) from the anal verge measured on rigid proctoscopy, and mean tumour size was 32 mm (range 8-73 mm). Three patients experienced complications needing intervention (Clavien-Dindo > 3A). Seventeen patients had rectal adenocarcinoma, 9 of whom underwent R0 completion total mesorectal excision (cTME). Fifty-five patients had an adenoma, 3 of whom developed recurrence (5.4%) within 12 months. All recurrences were treated successfully with a new TAMIS procedure. In addition, TAMIS was used in treatment of 2 patients with a neuroendocrine tumour, 1 patient with a haemangioma and 1 patient with a solitary rectal ulcer.

Conclusions: TAMIS surgery is associated with a low risk of complications and a low recurrence rate in rectal neoplasms. In cases of adenocarcinoma, R0 cTME surgery is feasible in the sub-group with high risk T1 and T2 tumours.

Keywords: Completion total mesorectal excision (cTME); Local excision; Rectal neoplasms; Recurrence; TAMIS.

PubMed Disclaimer

Conflict of interest statement

None of the authors have any disclosures.

Figures

Fig. 1
Fig. 1
Transanal minimally invasive surgery with submucosal excision. a Tumour at anterior wall seven to ten cm from anal verge. b Mucosal incision after submucosal elevation. c Dissection on the muscularis propria. d Complete dissection
See this image and copyright information in PMC

References

    1. Barendse RM, van Den Broek FJ, van Schooten J, Bemelman WA, Fockens P, de Graaf EJR. Endoscopic mucosal resection vs transanal endoscopic microsurgery for the treatment of large rectal adenomas. Colorectal Dis. 2012;14(4):191–196. doi: 10.1111/j.1463-1318.2011.02863.x. - DOI - PubMed
    1. Wibe A, Eriksen T, Syse A, Myrvold HE, Soreide G. Total mesorectal excision for rectal cancer–what can be achieved by a national audit? Colorectal Dis. 2003;5(5):471–477. doi: 10.1046/j.1463-1318.2003.00506.x. - DOI - PubMed
    1. Allaix ME, Arezzo Morino A. Transanal endoscopic microsurgery for rectal cancer: T1 and beyond? An evidence-based review. Surg Endosc. 2016;30(11):4841–4852. doi: 10.1007/s00464-016-4818-9. - DOI - PubMed
    1. Stornes T, Wibe A, Myklebust TA, Endreseth BH. National early rectal cancer treatment revisited. Dis Colon Rectum. 2016;59(7):623–629. doi: 10.1097/DCR.0000000000000591. - DOI - PubMed
    1. Jones HJS, Cunningham C, Nicholson GA, Hompes R. Outcomes following completion and salvage surgery for early rectal cancer: a systematic review. Eur J Surg Oncol. 2018;44(1):15–23. doi: 10.1016/j.ejso.2017.10.212. - DOI - PubMed

LinkOut - more resources