Abstract
Rectal cancer surgery has undergone a rapid change over the last few decades. We have come a long way from abdominoperineal resection to minimally invasive sphincter preserving techniques. Colorectal cancer screening programs made it possible to diagnose patients at earlier stages and this has led to question the necessity of radical surgery and the possibility of organ preservation. The platform most recently added to the surgical armamentarium is transanal minimally invasive surgery (TAMIS). It utilizes conventional laparoscopic tools to perform endoluminal surgery in rectum. Along with the conceptual changes in rectal cancer management, TAMIS is more frequently used for local excision of malignant rectal tumors. This review highlights the recent advances and current state of the role of TAMIS in the management of rectal cancer at various stages.
Highlights
The ultimate aim of rectal cancer treatment is to provide safe oncological cure while maintaining enteral continuity and preserving sphincter function
Since 2010, the introduction of minimally invasive approaches has been applied to the rectum via a transanal approach[3], and has been utilised in a broad spectrum of clinical scenarios; from transanal polyp excision to anastomotic leak repair, local excision of rectal cancer, transanal total mesorectal excision and pelvic exenteration[4,5,6,7,8,9]
The aim of this study is to review the current state of the role of transanal minimally invasive surgery (TAMIS) in the local management of rectal cancer and highlight the recent advances, with an emphasis on functional results and complications
Summary
The ultimate aim of rectal cancer treatment is to provide safe oncological cure while maintaining enteral continuity and preserving sphincter function. The multimodal treatment of rectal cancer is following a similar path to breast cancer: less invasive surgical techniques are being utilized to preserve anatomical and functional integrity without compromising oncological outcomes. It has undergone a seismic change from abdominoperineal resection to low anterior resection, local excision and watch-and-wait approach, following neoadjuvant treatment in select www.misjournal.net. Has the nomenclature around the operation changed, but so too has the platform to access the rectum. Since 2010, the introduction of minimally invasive approaches has been applied to the rectum via a transanal approach[3], and has been utilised in a broad spectrum of clinical scenarios; from transanal polyp excision to anastomotic leak repair, local excision of rectal cancer, transanal total mesorectal excision (taTME) and pelvic exenteration[4,5,6,7,8,9]
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