The Role of TAMIS (Transanal Minimally Invasive Surgery) in the Management of Advanced Rectal Cancer – One Shared Story of Three Exceptional Cases

ABSTRACT

Purpose of the study: The current gold standard for contemporary treatment of rectal cancer is total mesorectal excision (TME), achieving excellent local disease control and low recurrence rates. However, TME may be associated with postoperative mortality and quality of life deterioration. Therefore, the need to develop less radical treatment strategies has emerged. Transanal minimally invasive surgery (TAMIS) is currently indicated only for early rectal cancer. However, local excision following chemoradiation has yielded promising clinical outcomes in selected cases with more advanced disease. Materials and methods: We describe three cases of patients with advanced rectal cancer, who were managed with TAMIS, either due to patients' unwillingness to tolerate permanent colostomy or due to significant comorbidities. Results: Two of the three patients who also received adjuvant chemoradiation are still in remission for 18 and 15 months respectively. The third patient died early after hospital release due to unrelated causes. Conclusions: Local excision utilizing minimally invasive techniques, alongside with chemoradiotherapy and close follow up can be a viable alternative in carefully selected rectal cancer patients with advanced disease who deny permanent colostomy or are ineligible for major operations.

Keywords::

• rectal cancer
• advanced disease
• TAMIS
• TME

This article refers to:

Transanal Minimally Invasive Surgery: A Promising Alternative for Certain Advanced Rectal Cancer Patients

DECLARATION OF INTEREST

The authors report no conflicts of interest. The authors alone are responsible for the content and writing of the paper.

CONSENT

Signed forms of consent were obtained by the first two patients and the relatives of the third (deceased) patient.

ETHICS

This is a retrospective study and no experiments took place.

Additional information

Funding

The authors received no financial support for the research, authorship, and/or publication of this article.