Transanal endoscopic microsurgery and transanal minimally invasive surgery: is one technique superior?
BACKGROUND
Transanal endoscopic microsurgery (TEM) and transanal minimally invasive surgery (TAMIS) have been shown to improve the quality of transanal resections, allowing for improved visibility and access to the proximal rectum. This study compares the short-term outcomes between TEM and TAMIS among experienced colorectal surgeons.


METHODS
A retrospective review was conducted for TEM and TAMIS performed from 2012 to 2015 by local colorectal surgeons. Baseline patient demographics, operative variables, pathology results, and short-term outcomes were assessed.


RESULTS
Sixty-nine patients were identified (40 TEM and 29 TAMIS). Patient demographics, tumor characteristics, operative variables, margin status, and postoperative complications were similar for both. Volume of resection was higher for TAMIS (P < .001). Lymph node retrieval was achieved in 17.2% of TAMIS cases compared with 0% of TEM (P = .01).


CONCLUSIONS
TAMIS appears to have equivalent indications and outcomes compared with TEM. TAMIS is associated with larger specimens and more frequent presence of mesorectal lymph nodes.
Department of General Surgery, University of Nebraska Medical Center, 983280 Nebraska Medical Center, Omaha, NE 68198-3280, USA. Electronic address: aly.melin@unmc.edu.
Alyson A
AA
Melin
Department of General Surgery, University of Nebraska Medical Center, 983280 Nebraska Medical Center, Omaha, NE 68198-3280, USA.
Sudhir
S
Kalaskar
Department of General Surgery, Colon and Rectal Surgery Inc., Omaha, NE, USA.
Lindsay
L
Taylor
Department of General Surgery, University of Nebraska Medical Center, 983280 Nebraska Medical Center, Omaha, NE 68198-3280, USA.
Jon S
JS
Thompson
Department of General Surgery, University of Nebraska Medical Center, 983280 Nebraska Medical Center, Omaha, NE 68198-3280, USA; Department of General Surgery, Colon and Rectal Surgery Inc., Omaha, NE, USA; Department of General Surgery, Methodist Hospital, Omaha, NE, USA; Department of General Surgery, Creighton University Medical Center, Omaha, NE, USA.
Charles
C
Ternent
Department of General Surgery, University of Nebraska Medical Center, 983280 Nebraska Medical Center, Omaha, NE 68198-3280, USA.
Sean J
SJ
Langenfeld
D000368:Aged; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D061646:Operative Time; D056888:Patient Positioning; D012004:Rectal Neoplasms / Q000473:pathology / Q000601:surgery*; D012189:Retrospective Studies; D000067369:Transanal Endoscopic Microsurgery / Q000009:adverse effects / Q000379:methods*; D016896:Treatment Outcome
Rectal cancer; Transanal endoscopic microsurgery; Transanal minimally invasive surgery