Rauf A Wani
Colorectal Division,Sher-i-Kashmir Institute of Medical Sciences, Srinagar, INDIA
Title: Transanal Minimally Invasive Surgery (TAMIS) for rectal tumours
Biography
Biography: Rauf A Wani
Abstract
BACKGROUND : 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 traditional local excision can be approached using TAMIS.OBJECTIVE: The objective of our study was to assess the feasibility of TAMIS procedure in terms of intra operative & postoperative complications, operating time, resection margin positivity, hospital stay and local recurrence rate.METHODS: A total of 24 patients with rectal tumours (benign or early rectal cancer) located within 4 to 15 cm, occupying <40% of circumference and size < 4cm, who were subjected to TAMIS, prospectively over a period of 2 years were included in the study.RESULTS : TAMIS was performed for 16 benign and 8 adenocarcinomas, which were located at an average distance of 6.2 (4-10) cm from anal verge. The mean operating time was 72 (46-110) minutes. There were no intraoperative complications, however 1 (8.33%) patient suffered post operative bleeding, which was managed conservatively.2 (8.33%) patients developed acute urinary retention who required indwelling catheterisation. Resection margin was positive in 3 (12.5%) cases (2 adenocarcinomas and 1 villous adenoma). Average hospital stay was 2.7 (2-9) days. Follow up period ranged from 2 to 28 months. Local recurrence occurred in 2 (8.33%) villous adenoma patients (after 11 and 13 months), in whom redo TAMIS was done.CONCLUSION: TAMIS is a safe and feasible procedure for benign tumours and early rectal cancers, located in low and middle rectum.