Annals of Coloproctology

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Original Article

Transanal Minimally-Invasive Surgery for Treating Patients With Regressed Rectal Cancer After Preoperative Chemoradiotherapy: Byoung Chul Lee, Seonok Oh, Seok-Byung Lim, Chang Sik Yu, Jin Cheon Kim; Ann Coloproctol. 2017;33(2):52-56. Published online April 28, 2017; DOI: https://doi.org/10.3393/ac.2017.33.2.52

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Purpose

Although the standard treatment for patients with locally advanced rectal cancer managed by preoperative chemoradiotherapy (CRT) is a radical resection, local excisions are used in highly-selective cases. Recently, transanal minimally-invasive surgery (TAMIS) has emerged as a feasible technique for local excision of midrectal lesions. We assess the feasibility of using TAMIS to treat patients with locally advanced rectal cancer who showed good response to CRT.

Methods

From October 2010 to June 2013, 35 consecutive patients with rectal cancer managed by using preoperative CRT underwent TAMIS. After a single-incision laparoscopic surgery port had been introduced into the anal canal, a full-thickness local excision with conventional laparoscopic instruments was performed. We retrospectively reviewed a prospectively collected database of these cases.

Results

Of the 35 patients analyzed, 18 showed pathologic complete responses and 17 had residual lesions (2 ypTis, 4 ypT1, 9 ypT2, and 2 ypT3); 34 (97.1%) showed clear deep, lateral margins. The median distance of lesions from the anal verge was 5 cm. All procedures were completed laparoscopically, and the median operating time was 84 minutes. No intraoperative events or morbidities were seen in any of the patients, except one with wound dehiscence, who was treated conservatively. The median postoperative hospital stay and follow-up period were 4 days and 36 months, respectively. During the study period, no patients died, but 5 (14.3%) experienced recurrence, including one recurrence at the TAMIS site.

Conclusion

TAMIS seems to be a feasible, safe modality for treating patients with locally advanced rectal cancer who show good response to preoperative CRT.

Citations

Citations to this article as recorded by

Local Excision in the Era of Total Neoadjuvant Therapy
Anders C. Larsen, Joceline V. Vu
Clinics in Colon and Rectal Surgery.2026;[Epub] CrossRef
Efficacy, Safety and Oncological Outcomes of Minimally Invasive Approaches (EMR, ESD and TAMIS) for Early Rectal Tumors: A Systematic Review and Meta-Analysis
Mariam Hussain, Fatima Kayali, Abdelaziz O Surkhi, Roy Shartouni, Thurkga Moothathamby, Ahmed Akmal, Rohan Vyas, Leen Ammari, Ibrahim Sharaf, Mona Jaffar-Karballai, Mohamed Refaie, Yousif Jubouri, Matti Jubouri, Mohamad Bashir, Ali Murtada
Medical Devices: Evidence and Research.2026; Volume 19: 1. CrossRef
TAMIS: New Horizons in Modern Colorectal Surgery
Nurhilal Kızıltoprak, Jack Aaron, Camila Diez, Sam Atallah
Turkish Journal of Colorectal Disease.2025; 35(2): 33. CrossRef
Multidisciplinary treatment strategy for early rectal cancer
Gyung Mo Son, In Young Lee, Sung Hwan Cho, Byung-Soo Park, Hyun Sung Kim, Su Bum Park, Hyung Wook Kim, Sang Bo Oh, Tae Un Kim, Dong Hoon Shin
Precision and Future Medicine.2022; 6(1): 32. CrossRef
Minimally Invasive Treatment of a Completely Obstructed Rectal Anastomosis by Using a Transanal Plasmakinetic Resectoscope: a Case Report and Review of Literature
Na Wang, Daguang Wang, Weihua Tong, Jinguo Wang
Indian Journal of Surgery.2021; 83(5): 1127. CrossRef
Transanal minimally invasive surgery using laparoscopic instruments of the rectum: A review
Myung Jo Kim, Taek-Gu Lee
World Journal of Gastrointestinal Surgery.2021; 13(10): 1149. CrossRef
Transanal Minimally Invasive Surgery: A Promising Alternative for Certain Advanced Rectal Cancer Patients
Hernan A. Sanchez-Trejo, Daniel Hakakian, Terrence Curran, Luca Antonioli, Balazs Csoka, Zoltan H. Nemeth
Journal of Investigative Surgery.2019; 32(4): 377. CrossRef
Transanal minimally invasive surgery as a treatment option for a completely occluded anastomosis after low anterior resection: A new approach to severe anastomotic stenosis
Jun Woo Bong, Seok‐Byung Lim
Asian Journal of Endoscopic Surgery.2019; 12(2): 175. CrossRef
A systematic review and meta-analysis of pT2 rectal cancer spread and recurrence pattern: Implications for target design in radiation therapy for organ preservation
Joanna Socha, Lucyna Pietrzak, Anna Zawadzka, Anna Paciorkiewicz, Anna Krupa, Krzysztof Bujko
Radiotherapy and Oncology.2019; 133: 20. CrossRef
Transanal Minimally Invasive Surgery After Chemoradiotherapy: Widening Scope of Indications for Local Excision
Min Jung Kim, Jae Hwan Oh
Annals of Coloproctology.2017; 33(2): 43. CrossRef

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