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

Abstract

BackgroundThe 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.MethodsRetrospective 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.ResultsFifty-three patients underwent TEM procedure and 68 patients underwent TAMIS. Operating time was significantly shorter for TAMIS compared with TEM (median 45 vs 65min, 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.ConclusionsTAMIS is a valuable alternative to TEM, leading to decreased operating times, because all resections can be done in lithotomy position.