title: Transanal Minimally Invasive Surgery for Rectal Lesions.
abstract: OBJECTIVE
  Transanal minimally invasive surgery (TAMIS) has emerged as an alternative to transanal endoscopic microsurgery (TEM). The authors report their experience with TAMIS for the treatment of mid and high rectal tumors.
  
  
  METHODS
  From November 2011 through May 2016, 31 patients (21 females, 68%), with a median age of 65 years who underwent single-port TAMIS were prospectively enrolled. Mean distance from the anal verge of the rectal tumors was 9.5 cm. Seventeen patients presented with T1 cancer, 10 with large adenoma, 2 with gastrointestinal stromal tumor (GIST) and 2 with carcinoid tumor. Data concerning demographics, operative procedure and pathologic results were analyzed.
  
  
  RESULTS
  TAMIS was successfully completed in all cases. In 4 (13%) TAMIS was converted to standard Park's transanal technique. Median postoperative stay was 3 days. The overall complication rate was 9.6%, including 1 urinary tract infection, 1 subcutaneous emphysema, and 1 hemorrhoidal thrombosis. TAMIS allowed an R0 resection in 96.8% of cases (30/31 cases) and a single case of local recurrence after a large adenoma resection was encountered.
  
  
  CONCLUSIONS
  TAMIS is a safe technique, with a short learning curve for laparoscopic surgeons already proficient in single-port procedures, and provides effective oncological outcomes compared to other techniques.
authors.affiliation: Department of General Surgery; University of Rome "Tor Vergata," Rome, Italy.
authors.forename: Silvia
authors.initials: S
authors.lastname: Quaresima
authors.affiliation: Department of General Surgery; University of Rome "Tor Vergata," Rome, Italy.
authors.forename: Andrea
authors.initials: A
authors.lastname: Balla
authors.affiliation: Department of General Surgery; University of Rome "Tor Vergata," Rome, Italy.
authors.forename: Luana
authors.initials: L
authors.lastname: Franceschilli
authors.affiliation: Department of General Surgery; University of Rome "Tor Vergata," Rome, Italy.
authors.forename: Marco
authors.initials: M
authors.lastname: La Torre
authors.affiliation: Department of General Surgery; University of Rome "Tor Vergata," Rome, Italy.
authors.forename: Corrado
authors.initials: C
authors.lastname: Iafrate
authors.affiliation: Department of General Surgery; University of Rome "Tor Vergata," Rome, Italy.
authors.forename: Mostafa
authors.initials: M
authors.lastname: Shalaby
authors.affiliation: Department of General Surgery; University of Rome "Tor Vergata," Rome, Italy.
authors.forename: Nicola
authors.initials: N
authors.lastname: Di Lorenzo
authors.affiliation: Department of General Surgery; University of Rome "Tor Vergata," Rome, Italy.
authors.forename: Pierpaolo
authors.initials: P
authors.lastname: Sileri
mesh_terms: D000236:Adenoma / Q000601:surgery*; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002276:Carcinoid Tumor / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D046152:Gastrointestinal Stromal Tumors / Q000601:surgery*; D006801:Humans; D010535:Laparoscopy / Q000295:instrumentation / Q000379:methods*; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012004:Rectal Neoplasms / Q000601:surgery*; D000067368:Transanal Endoscopic Surgery / Q000295:instrumentation / Q000379:methods*; D016896:Treatment Outcome
keywords: Colorectal surgery; Natural orifice transluminal endoscopic surgery (NOTES) Single-site laparoscopic surgery (SILS); Surgical oncology; Transanal minimally invasive Surgery (TAMIS)