TAMIS for Recurrent Cancer of the High Rectum (25 cm from the Anal Verge) in a Patient with Serious Associated Disorders (Rescue Surgery)

INTRODUCTION Transanal Minimally invasive surgery (TAMIS) is indicated for benign lesions of the rectum distant up to 5 cm and not exceeding more than 1/3 of the rectal circumference; for early stage malignancies confined to the submucosa (T1 sm1 according to the Kikuchi classification); for cancers...

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Autores principales:	Alessandro Verbo, Vito Laterza, Marco Montagna, Giovanni Di Palma, Giovanni Moschetta, Annamaria Martullo
Formato:	article
Lenguaje:	EN
Publicado:	Shiraz University of Medical Sciences 2021
Materias:	transanal minimally invasive surgery (tamis) rectal cancer laparoscopic surgery Medicine R
Acceso en línea:	https://doaj.org/article/6f64c12a65184a27a0001a2c9e01f973
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spelling	oai:doaj.org-article:6f64c12a65184a27a0001a2c9e01f9732021-11-14T06:50:43ZTAMIS for Recurrent Cancer of the High Rectum (25 cm from the Anal Verge) in a Patient with Serious Associated Disorders (Rescue Surgery)2783-243010.30476/acrr.2021.91751.1106https://doaj.org/article/6f64c12a65184a27a0001a2c9e01f9732021-06-01T00:00:00Zhttps://colorectalresearch.sums.ac.ir/article_47683_9f97fc04733613559cdf759b63b4a3fb.pdfhttps://doaj.org/toc/2783-2430INTRODUCTION Transanal Minimally invasive surgery (TAMIS) is indicated for benign lesions of the rectum distant up to 5 cm and not exceeding more than 1/3 of the rectal circumference; for early stage malignancies confined to the submucosa (T1 sm1 according to the Kikuchi classification); for cancers after complete response to neoadiuvant treatments or with T1 residue (due to a risk of mesorectal positive lymph node between 3-6%); for T2-T3 N0 in patients who cannot undergo major surgical resections due to a compromised general (rescue surgery). TAMIS is especially recommended for neoplasms located at a distance between 5 and 18 cm from the anal verge. CASE PRESENTATION We performed TAMIS on a 72-year-old patient diagnosed with diffuse polyposis syndrome (FAP), with multimorbidity and a history of recurrences, all treated with surgical resection, AND with a new recurrence on the ileo-rectal anastomosis at about 25 cm from the anal verge. A rectoscopy and a total body CT were performed (anastomotic level; size 2 cm; staging: cT1-2, N0, M0; histology: adenocarcinoma). The final decision after multidisciplinary meeting was for TAMIS, due to high intra- and post-operative risk contraindicating major surgery. Data regarding total operating time, blood losses, length of stay, surgical and general intra and post-operative complications, resumption of nutrition and therapies (antibiotics and pain relievers) were collected. The operation was successful, with a total operating time of 55 minutes, and an estimated blood loss of 20 ml. The patient was rapidly mobilized and nutrition promptly resumed. The length of stay was 3 days. We did not observe any complications. CONCLUSION We showed for this patient the feasibility and safety of TAMIS resections at greater distances than those normally recommended.Alessandro VerboVito LaterzaMarco MontagnaGiovanni Di PalmaGiovanni MoschettaAnnamaria MartulloShiraz University of Medical Sciencesarticletransanal minimally invasive surgery (tamis)rectal cancerlaparoscopic surgeryMedicineRENIranian Journal of Colorectal Research, Vol 9, Iss 2, Pp 82-85 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	transanal minimally invasive surgery (tamis) rectal cancer laparoscopic surgery Medicine R
spellingShingle	transanal minimally invasive surgery (tamis) rectal cancer laparoscopic surgery Medicine R Alessandro Verbo Vito Laterza Marco Montagna Giovanni Di Palma Giovanni Moschetta Annamaria Martullo TAMIS for Recurrent Cancer of the High Rectum (25 cm from the Anal Verge) in a Patient with Serious Associated Disorders (Rescue Surgery)
description	INTRODUCTION Transanal Minimally invasive surgery (TAMIS) is indicated for benign lesions of the rectum distant up to 5 cm and not exceeding more than 1/3 of the rectal circumference; for early stage malignancies confined to the submucosa (T1 sm1 according to the Kikuchi classification); for cancers after complete response to neoadiuvant treatments or with T1 residue (due to a risk of mesorectal positive lymph node between 3-6%); for T2-T3 N0 in patients who cannot undergo major surgical resections due to a compromised general (rescue surgery). TAMIS is especially recommended for neoplasms located at a distance between 5 and 18 cm from the anal verge. CASE PRESENTATION We performed TAMIS on a 72-year-old patient diagnosed with diffuse polyposis syndrome (FAP), with multimorbidity and a history of recurrences, all treated with surgical resection, AND with a new recurrence on the ileo-rectal anastomosis at about 25 cm from the anal verge. A rectoscopy and a total body CT were performed (anastomotic level; size 2 cm; staging: cT1-2, N0, M0; histology: adenocarcinoma). The final decision after multidisciplinary meeting was for TAMIS, due to high intra- and post-operative risk contraindicating major surgery. Data regarding total operating time, blood losses, length of stay, surgical and general intra and post-operative complications, resumption of nutrition and therapies (antibiotics and pain relievers) were collected. The operation was successful, with a total operating time of 55 minutes, and an estimated blood loss of 20 ml. The patient was rapidly mobilized and nutrition promptly resumed. The length of stay was 3 days. We did not observe any complications. CONCLUSION We showed for this patient the feasibility and safety of TAMIS resections at greater distances than those normally recommended.
format	article
author	Alessandro Verbo Vito Laterza Marco Montagna Giovanni Di Palma Giovanni Moschetta Annamaria Martullo
author_facet	Alessandro Verbo Vito Laterza Marco Montagna Giovanni Di Palma Giovanni Moschetta Annamaria Martullo
author_sort	Alessandro Verbo
title	TAMIS for Recurrent Cancer of the High Rectum (25 cm from the Anal Verge) in a Patient with Serious Associated Disorders (Rescue Surgery)
title_short	TAMIS for Recurrent Cancer of the High Rectum (25 cm from the Anal Verge) in a Patient with Serious Associated Disorders (Rescue Surgery)
title_full	TAMIS for Recurrent Cancer of the High Rectum (25 cm from the Anal Verge) in a Patient with Serious Associated Disorders (Rescue Surgery)
title_fullStr	TAMIS for Recurrent Cancer of the High Rectum (25 cm from the Anal Verge) in a Patient with Serious Associated Disorders (Rescue Surgery)
title_full_unstemmed	TAMIS for Recurrent Cancer of the High Rectum (25 cm from the Anal Verge) in a Patient with Serious Associated Disorders (Rescue Surgery)
title_sort	tamis for recurrent cancer of the high rectum (25 cm from the anal verge) in a patient with serious associated disorders (rescue surgery)
publisher	Shiraz University of Medical Sciences
publishDate	2021
url	https://doaj.org/article/6f64c12a65184a27a0001a2c9e01f973
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TAMIS for Recurrent Cancer of the High Rectum (25 cm from the Anal Verge) in a Patient with Serious Associated Disorders (Rescue Surgery)

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