Transanal Minimally-Invasive Surgery (TAMIS): Experience with No Closure of the Rectal Defect

Abstract: Background In transanal minimally-invasive surgery (TAMIS), the closure of the rectal defect is controversial, and endoluminal suture is one of the most challenging aspects. The goal of the present study is to evaluate the short- and medium-term complications of a consecutive series of patients with extraperitoneal rectal injuries who underwent TAMIS without closure of the rectal defect. Materials and Methods A prospective, longitudinal, descriptive study conducted between August 2013 and July 2019 in which all patients with extraperitoneal rectal lesions, who were operated on using the TAMIS technique, were consecutively included. The lesions were: benign lesions ≥ 3 cm; neuroendocrine tumors ≤ 2 cm; adenocarcinomas in stage T1N0; and adenocarcinomas in stage T2N0, with high surgical risk, or with the patients reluctant to undergo radical surgery, and others with doubts about complete remission after the neoadjuvant therapy. Bleeding, infectious complications, rectal stenosis, perforations, and death were evaluated. Results A total of 35 patients were treated using TAMIS without closure of the defect. The average size of the lesions was of 3.68 ± 2.1 cm (95% confidence interval [95%CI]: 0.7 cm to 9 cm), their average distance from the anal margin was of 5.7 ± 1.48 cm, and the average operative time was of 39.2 ± 20.5 minutes, with a minimum postoperative follow-up of 1 year. As for the pathologies, they were: 15 adenomas; 3 carcinoid tumors; and 17 adenocarcinomas. In all cases, the rectal defect was left open. The overall morbidity was of 14.2%. Two patients (grade II in the Clavien-Dindo classification) were readmitted for pain treatment, and three patients (grade III in the Clavien-Dindo classification) were assisted due to postoperative bleeding, one of whom required reoperation. Conclusion The TAMIS technique without closure of the rectal defect yields good results, and present a high feasibility and low complication rate.

Standort
Deutsche Nationalbibliothek Frankfurt am Main
Umfang
Online-Ressource
Sprache
Englisch

Erschienen in
Transanal Minimally-Invasive Surgery (TAMIS): Experience with No Closure of the Rectal Defect ; volume:41 ; number:04 ; year:2021 ; pages:348-354
Journal of coloproctology ; 41, Heft 04 (2021), 348-354

Beteiligte Personen und Organisationen
Naiderman, Diego
Tufare, Ana Laura
Trinchero, Lady Beatriz
Rossi, Fernando
Dolan, Martín
Cano, Diego Martín
Fagalde, Rafael López
Jury, Gastón Leonardo

DOI
10.1055/s-0041-1735642
URN
urn:nbn:de:101:1-2022031915163962491346
Rechteinformation
Open Access; Der Zugriff auf das Objekt ist unbeschränkt möglich.
Letzte Aktualisierung
15.08.2025, 07:28 MESZ

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Beteiligte

  • Naiderman, Diego
  • Tufare, Ana Laura
  • Trinchero, Lady Beatriz
  • Rossi, Fernando
  • Dolan, Martín
  • Cano, Diego Martín
  • Fagalde, Rafael López
  • Jury, Gastón Leonardo

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