Carolina C. González-Gómez, Aurora Burgos García, Miguel León Arellano, Pedro de María Pallarés, Lidia Cristóbal Poch and Ramón Cantero Cid*
Department of General and Digestive Surgery, University Hospital La Paz, SpainFulltext PDF
The standard care treatment for rectal cancer is radical surgery, including total mesorectal excision (TME). The management of early stage rectal cancer is based on finding the right balance between optimal oncologic outcomes and acceptable adverse effects for the patient. Trying to minimize the morbidity associated with radical surgery, alternative approaches have been created, including transanal endoscopic microsurgery (TEM) transanal endoscopic operation (TEO) and transanal minimally invasive surgery (TAMIS). Transanal minimally invasive surgery is a safe and effective technique for the resection of lesions located in the middle and upper third of the anus, so benign nature and neoplastic lesions T1N0 stage. The use of this technique in T2 lesions, today is controversial, and requires individual assessment of each case. The correct patient selection allows transanal resections having similar oncological long-term results versus conventional surgery, with a significant reduction in complications. In our experience, long-term oncologic results, and low morbidity and mortality let transanal minimally invasive surgery applicable for rectal lesions, also lower costs and shorter learning curve make a better option than TEM, due to the use of laparoscopic instruments in this field.
Gonzalez-Gomez CC, Garcia AB, Arellano ML, de Maria Pallares P, Poch LC, Cid RC. Transanal Surgery: New Therapeutic Tools. Clin Surg. 2016; 1: 1202.