Is partial thickness excision in TAMIS without defect suture safe for benign rectal lesions?

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COD: 12_2795 Categorie: ,

Ali Kilic, Abdullah Sisik

Ann. Ital. Chir., 2018 89, 2: 177-181

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BACKGROUND: One of the minimally invasive methods used in the surgical treatment of large-based polypoid lesions located
in the rectum is transanal minimally invasive surgery (TAMIS). This method, which relieves patients from the severe
morbidities of invasive surgical procedures, is performed in both malign (T1-T2) and benign lesions. Difficulty of suturation
after TAMIS emerges as the most important factor to prolong the procedure. We aimed to analyse the efficacy of
TAMIS procedure with partial thickness resection without suturation.
MATERIALS AND METHODS: This was a retrospective study. The study was conducted in a Turkish Education and Research
Hospital in 2016. Data of 10 patients who diagnosed with benign rectal masses were included in the study. Patients
who were suspected for muscularis propria invasion and lymph node positivity in magnetic resonance imaging preoperatively
excluded from the study. All lesions were resected with TAMIS and the mucosal defects were not closed in any
patients. Demographic features, lesion’s distances to anal verge, excised lesion’s size, histopathological report, operation times,
duration of hospital stay and complications were recorded
RESULTS: Six male and 4 female patients were treated. The mean distance to the anal werge of the lesions was 8.5
(5-12) cm. The longest diameters of the lesions ranged from 1-4 cm in length. All the patients were discharged the day
after the surgery. Operation times were found to be 46.1 ± 5 min (30-70). Histopathological examinations of the removed
lesions revealed villous adenomas in 3 patients, villous adenoma and Tis adenocarcinoma in 5 patients, villous adenoma
and T1 adenocarcinoma in 1 patient and neuroendocrine tumor in 1 patient. There were no early complications
such as bleeding, and late complications such as perforation, anal incontinence or anorectal dysfunction in any patient.
No evidence of recurrence was found in any of the patients under control rectosigmoidoscopy and pelvic MRI examinations.
CONCLUSION: Partial thickness resection of rectal benign lesions by TAMIS method is safe. After resection some surgeons
suggest to close the defect by suture or stapler. In our study resection without closure of the defect is found safe and feasible
with limited patient prejudice.

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