Endoscopic Surgery in Rectal Cancer- A Review

Abstract

Colorectal cancer is one of the leading causes of cancer-related deaths worldwide. Total mesorectal excision (TME) remains the gold standard treatment for any stage of rectal cancer, especially in more advanced disease, as it effectively treats the mesorectal lymph nodes and reduces recurrence [1]. Minimally invasive abdominal approach has been established to be oncologically safe, feasible and associated with all the advantages of minimal access surgery, however, it has not had a measurable impact on the incidence of postoperative complications, sexual and urinary dysfunction, or quality of life. TME performed either via open, laparoscopic or robotic approach is accompanied by significant morbidity and mortality [2]. In addition, widespread adoption of laparoscopic techniques in colorectal surgery has been limited by the technical complexity and steep learning curve. In an effort to harness the advantages of a minimally invasive approach to benefit patients with colorectal pathology, trans anal natural orifice transluminal endoscopic surgery (NOTES) has been explored, with promising preliminary results, particularly when used for rectal cancer and other benign lesions. NOTES in Rectal lesions can be carried out using Transanal Endoscopic Microsurgery (TEMS) and Transanal Minimal Invasive Surgery (TAMIS), which can be together termed as Transanal endoscopic surgery. JMS 2018;21(1):3-10