Abstract
BackgroundTransanal minimally invasive surgery (TAMIS) is emerging as an alternative to transanal endoscopic microsurgery. Quality of life (QOL) and functional outcome are important aspects when valuing a new technique. The aim of this prospective study was to assess both functional outcome and QOL after TAMIS.MethodsFrom 2011 to 2013, patients were prospectively studied prior to and at least 6 months after TAMIS for rectal adenomas and low-risk T1 carcinomas using a single-site laparoscopy port. Functional outcome was determined using the Faecal Incontinence Severity Index (FISI). Quality of life was measured using functional [Faecal Incontinence Quality of Life (FIQL)] and generic (EuroQol EQ-5D) questionnaires.ResultsThe study population consisted of 24 patients 13 men, median age 59 (range 42–83) with 24 tumours [median distance from the dentate line 8 cm (range 2–17 cm); median tumour size 6 cm2 (range 0.25–51 cm2); 20 adenomas; 4 low-risk T1 carcinomas]. Post-operative complications occurred in one patient (4 %; grade IIIb according to Clavien Dindo classification). Compared to baseline, FISI remained unaffected (9.8 vs 7.3; P = 0.26), FIQL remained unaffected, and EuroQol EQ-5D improved (EQ-VAS: 77 vs 83; P = 0.04).ConclusionThere was no detrimental effect of TAMIS on anorectal function. Overall QOL was improved after TAMIS, probably due to removal of the tumour, and at 6 months was equal to the general population.
Highlights
Transanal minimally invasive surgery (TAMIS) is emerging as an alternative to transanal endoscopic microsurgery
The study population consisted of 24 patients 13 men, median age 59 with 24 tumours [median distance from the dentate line 8 cm; median tumour size 6 cm2; 20 adenomas; 4 low-risk T1 carcinomas]
Overall Quality of life (QOL) was improved after TAMIS, probably due to removal of the tumour, and at 6 months was equal to the general population
Summary
Transanal minimally invasive surgery (TAMIS) is emerging as an alternative to transanal endoscopic microsurgery. Quality of life (QOL) and functional outcome are important aspects when valuing a new technique. The aim of this prospective study was to assess both functional outcome and QOL after TAMIS. For the local resection of rectal adenomas and selected rectal carcinomas, transanal endoscopic microsurgery (TEM), as described by Buess, has emerged as the treatment of choice as it is superior to other local excision techniques [1,2,3]. Since 2010, single-site surgical ports are used as an alternative to the classical TEM rectoscope in transanal surgery.
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