Transanal minimal invasive surgery (TAMIS): safety and feasibility for the resection of benign and malignant lesions of the rectum
Asif Mehraj, Najmus Saqib, Rauf Wani, Nisar Chowdri, Fazl Parray, Mudassir Khan
Department Colorectal Surgery, Sher-i-Kashmir Institute of Medical Sciences, Srinagar, India
Abstract
Objective: Radical surgery for rectal tumours has high morbidity. Local excision of such tumours can be achieved without compromising oncologic safety. However tumours that are not accessible to local excision can be approached using Transanal Minimal Invasive Surgery (TAMIS). The aim of our study was to assess feasibility of TAMIS procedure in terms of complications, operating time, resection margin positivity, hospital stay and local recurrence rate.
Material and Methods: Forty eight patients with benign adenomas or early stage adenocarcinoma, within 4 to 12 cm from anal verge who were subjected to TAMIS over a period of 3 years were included in the study. Short and long term outcomes were assessed.
Results: TAMIS was performed for 36 benign adenomas and 12 adenocarcinomas, which were located at an average distance of 6.2 cm from anal verge. The mean operating time was 72 minutes. There were no intraoperative complications.1 (2.08%) patient suffered post operative bleeding, which was managed conservatively. 2 (4.16%) patients developed acute urinary retention who required indwelling catheterisation. Resection margin was positive in 3 (6.25%) benign cases. Average hospital stay was 2.7 days. Local recurrence occurred in 2 (4.16%) villous adenoma patients (after 11 and 13 months), whereas in malignant patients there was no recurrence at a follow up period ranging between 12 to 36 months.
Conclusion: TAMIS is a safe and feasible procedure for benign tumours and early rectal cancers, located in low and middle rectum.
Keywords: Tamis, tubulovillous adenoma, early rectal cancer
Cite this article as: Mehraj A, Saqib N, Wani R, Chowdri N, Parray F, Khan M. Transanal minimal invasive surgery (TAMIS): safety and feasibility for the resection of benign and malignant lesions of the rectum. Turk J Surg 2021; 37 (1): 14-20.
The approval for this study was obtained from Institutional Ethics Committee of Sher-i-Kashmir Institute of Medical Sciences, Srinagar (Decision no: 23/2015 Date: 29.06.2015).
Externally peer-reviewed.
Concept - N.A.C., R.A.W., N.S., F.Q.P.; Design - N.S., N.A.C., R.A.W., F.Q.P.; Supervision -N.A.C., A.M., R.A.W.; F.Q.P.; Materials - N.A.C., R.A.W., F.Q.P., M.K.; Data Collection and/or Processing - A.M., N.S., M.K.; Analysis and Interpretation - A.M., N.S., M.K., R.A.W.; Literature Review - A.M., N.A.C., F.Q.P., R.A.W., N.S.; Writing Manuscript - A.M., R.A.W, N.A.C., M.K., N.S. Critical Reviews - A.M., F.Q.P., N.A.C., R.A.W.
The authors declare that they have no conflict of interest.
The authors declared that this study has received no financial support.
Dr. Semra Demirli Atici for translating the abstract to Turkish Language.