The effect of implementing a transanal minimally invasive surgical programme for the local excision of early rectal neoplasia on outcomes in a tertiary referral rectal cancer centre.
Eur J Gastroenterol Hepatol
; 36(7): 861-866, 2024 Jul 01.
Article
en En
| MEDLINE
| ID: mdl-38625823
ABSTRACT
Transanal minimally invasive surgery (TAMIS) is a surgical alternative to proctectomy in the management of complex rectal polyps and early rectal cancers. In 2016, our institution introduced a TAMIS programme. The purpose of this study was to evaluate changes in practice and outcomes in our institution in the 3â
years before and after the implementation of TAMIS. We conducted a retrospective analysis of a prospective database of patients who underwent proctectomy or TAMIS for the management of complex rectal polyps or early rectal cancers at our institution between 2013 and 2018. 96 patients were included in this study (41 proctectomy vs 55 TAMIS). A significant reduction was noted in the number of proctectomies performed in the 3â
years after the implementation of TAMIS as compared to the 3â
years before (13 vs 28) ( P â
<â
0.001); 43% of patients ( n â
=â
12) who underwent proctectomy in the period prior to implementation of TAMIS were American Society of Anaesthesiologists grade III, as compared to only 15% ( n â
=â
2) of patients during the period following TAMIS implementation ( P â
=â
0.02). TAMIS was associated with a significant reduction in length of inpatient stay ( P â
<â
0.001). Oncological outcomes were comparable between groups (log rank P â
=â
0.83). Our findings support TAMIS as a safe and effective alternative to radical resection. The availability of TAMIS has resulted in a significant reduction in the number of comorbid patients undergoing proctectomy at our institution. Consequently, we have observed a significant reduction in postoperative complications over this time period.
Texto completo:
1
Colección:
01-internacional
Base de datos:
MEDLINE
Asunto principal:
Neoplasias del Recto
/
Centros de Atención Terciaria
/
Cirugía Endoscópica Transanal
/
Proctectomía
/
Tiempo de Internación
Límite:
Aged
/
Female
/
Humans
/
Male
/
Middle aged
Idioma:
En
Revista:
Eur J Gastroenterol Hepatol
Asunto de la revista:
GASTROENTEROLOGIA
Año:
2024
Tipo del documento:
Article