Trans-anal minimally invasive surgery for rectal neoplasia: Experience from single tertiary institution in China

World J Gastrointest Oncol. 2018 Jun 15;10(6):137-144. doi: 10.4251/wjgo.v10.i6.137.


Aim: To evaluate the feasibility and safety of trans-anal minimally invasive surgery (TAMIS) from single institute in China.

Methods: A retrospective review was conducted for patients with rectal neoplasia, who underwent TAMIS using single incision laparoscopic surgery-Port from January 2013 till January 2016 by a group of colorectal surgeons from Gastrointestinal Center Unit III, Peking University Cancer Hospital. Patients' demographic data, surgical related information, post-operational pathology, as well as peri-operative follow-up were all collected.

Results: Twenty-five patients with rectal neoplasia were identified consequently. Complete full-thickness excision was achieved in all cases without conversion. 22 (88%) cases had rectal malignancies [6 were adenocarcinomas and 16 were neuroendocrine tumors (NET)], while 3 patients had adenomas. Mean surgical duration was 61.3 min, and mean post-operative stay were 2.7 d. Post-operational examination demonstrated 5 cases had positive resection margin: 2 adenocarcinoma cases and 1 NET case with positive lateral margin, and the other 2 NET cases with positive basal margin. The curve of operation time for TAMIS cases suggested a minimum of 10 cases for a laparoscopic surgeon proficient with this technique.

Conclusion: TAMIS was demonstrated to be reproducible and safe, with a relatively short learning process for laparoscopic surgeons in selected cases for rectal neoplasia. Long-term oncological outcome needs to be determined by further investigation.

Keywords: Rectal neoplasia; Resection margin; Trans-anal minimally invasive surgery.