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Comparison of Transanal Minimally Invasive Surgery (TAMIS) and Transanal Endoscopic Operations (TEO)

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Abstract

Rectal lesions, benign or malignant, are one of the most encountered clinical entities in general surgery departments. Technological breakthroughs in local excision techniques have been occurring such as transanal endoscopic microsurgery (TEM), transanal minimally invasive surgery (TAMIS), and transanal endoscopic operations (TEO) during the last two decades. We compared the results between TAMIS and TEO for removing rectal lesions. The study was conducted on patients who underwent TAMIS and TEO interventions due to rectal lesions between 2010 and 2015 in the Department of General Surgery of Gulhane Military Medical Academy and the University of Ankara. The data for these patients relating to their age, gender, distance from the anal verge, operation time, occurrence of first bowel movement after surgery, initiation of oral intake after surgery, length of hospital stay, tumor size, follow-up, complications, free resection margin, recurrence, postoperative Fecal Incontinence Severity Index (FISI) and visual analog scale (VAS) scores, and pathologic specimen examination were taken from the hospital’s electronic database. All data were enrolled and analyzed statistically. The TAMIS group had 23 (54.8%) patients, and the TEO group had 19 (45.2%) patients. The TAMIS operation time was significantly longer than that of TEO (Z = 3.188; P < 0.001). Median time to first bowel movement in the TAMIS group was 36.0 h (interquartile range (IQR) = 12.0) vs. 24.0 h (IQR = 18.0) in the TEO group; the difference was significant (Z = 3.358; P = 0.001). No significant differences were found between the two groups in complication rate, recurrence, visual analog scale, or Fecal Incontinence Severity Index. TAMIS and TEO techniques have been found to produce almost similar results. These two techniques are considered to be good alternatives to conservative treatment methods with their reliability and feasibility in experienced hands for selected patients. For TAMIS and TEO techniques to qualify as “treatment of choice,” prospective randomized clinical trials are needed.

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Acknowledgments

The authors thank Marilyn Carlson for her editorial assistance.

Author information

Authors and Affiliations

  1. Gulhane Medical Faculty, Department of General Surgery, University of Health Sciences, Etlik, 06010, Ankara, Turkey

    Şahin Kaymak

  2. Department of Metabolic Surgery, Special Etiler Hospital, Istanbul, Turkey

    Hüseyin Sinan

  3. Department of General Surgery, Diskapi Yildirim Beyazit Training and Research Hospital, Ankara, Turkey

    Mehmet Saydam

  4. Department of Statistics, University of Yildirim Beyazit, Ankara, Turkey

    Hilal Hatice Aktaş

  5. Medical Faculty, Department of General Surgery, University of Ankara, Ankara, Turkey

    Ethem Gecim

  6. Department of General Surgery, Special TOBB ETU Hospital, Ankara, Turkey

    Sezai Demirbas

Authors
  1. Şahin Kaymak
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  2. Hüseyin Sinan
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  3. Mehmet Saydam
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  4. Hilal Hatice Aktaş
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  5. Ethem Gecim
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  6. Sezai Demirbas
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Contributions

Idea/concept: SD, EG, HS

Design: HS, ŞK, SD

Control/supervision: SD, EG

Data collection and/or processing: ŞK, HS

Analysis and/or interpretation: HHA, HS, MS

Literature review: HS, MS, ŞK

Writing the article: ŞK, HS

Critical review: SD

Corresponding author

Correspondence to Şahin Kaymak.

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The study was approved by the local ethics committee.

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The authors declare that they have no conflicts of interest.

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Kaymak, Ş., Sinan, H., Saydam, M. et al. Comparison of Transanal Minimally Invasive Surgery (TAMIS) and Transanal Endoscopic Operations (TEO). Indian J Surg 82, 319–324 (2020). https://doi.org/10.1007/s12262-019-01943-y

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  • DOI: https://doi.org/10.1007/s12262-019-01943-y

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