Clin Colon Rectal Surg 2017; 30(02): 112-119
DOI: 10.1055/s-0036-1597315
Review Article
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Transanal Minimally Invasive Surgery

Earl V. Thompson
1   Department of Surgery, University of Pennsylvania Health System, Philadelphia, Pennsylvania
,
Joshua I. S. Bleier
1   Department of Surgery, University of Pennsylvania Health System, Philadelphia, Pennsylvania
› Author Affiliations
Further Information

Publication History

Publication Date:
04 April 2017 (online)

Abstract

Transanal endoscopic surgery (TES) techniques encompass a variety of approaches, including transanal endoscopic microsurgery and transanal minimally invasive surgery. These allow a surgeon to perform local excision of rectal lesions with minimal morbidity and the potential to spare the need for proctectomy. As understanding of the long-term outcomes from these procedures has evolved, so have the indications for TES. In this study, we review the development of TES, its early results, and the evolution of new surgical techniques. In addition, we evaluate the most recent research on indications and outcomes in rectal cancer.

 
  • References

  • 1 Buess G, Theiss R, Hutterer F , et al. Transanal endoscopic surgery of the rectum - testing a new method in animal experiments [in German]. Leber Magen Darm 1983; 13 (2) 73-77
  • 2 Buess G, Theiss R, Günther M, Hutterer F, Pichlmaier H. Endoscopic surgery in the rectum. Endoscopy 1985; 17 (1) 31-35
  • 3 Buess G, Kipfmüller K, Ibald R , et al. Clinical results of transanal endoscopic microsurgery. Surg Endosc 1988; 2 (4) 245-250
  • 4 Buess G, Kipfmüller K, Naruhn M, Braunstein S, Junginger T. Endoscopic microsurgery of rectal tumors. Endoscopy 1987; 19 (Suppl. 01) 38-42
  • 5 Atallah S, Albert M, Larach S. Transanal minimally invasive surgery: a giant leap forward. Surg Endosc 2010; 24 (9) 2200-2205
  • 6 Rimonda R, Arezzo A, Arolfo S, Salvai A, Morino M. TransAnal minimally invasive surgery (TAMIS) with SILS port versus transanal endoscopic microsurgery (TEM): A comparative experimental study. Surg Endosc 2013; 27 (10) 3762-3768
  • 7 Hompes R, Rauh SM, Ris F, Tuynman JB, Mortensen NJ. Robotic transanal minimally invasive surgery for local excision of rectal neoplasms. Br J Surg 2014; 101 (5) 578-581
  • 8 Deijen CL, Velthuis S, Tsai A , et al. COLOR III: a multicentre randomised clinical trial comparing transanal TME versus laparoscopic TME for mid and low rectal cancer. Surg Endosc 2016; 30 (8) 3210-3215
  • 9 Smith LE, Ko ST, Saclarides T, Caushaj P, Orkin BA, Khanduja KS. Transanal endoscopic microsurgery. Initial registry results. Dis Colon Rectum 1996; 39 , (10 Suppl): S79-S84
  • 10 Kinoshita T, Kanehira E, Omura K, Tomori T, Yamada H. Transanal endoscopic microsurgery in the treatment of rectal carcinoid tumor. Surg Endosc 2007; 21 (6) 970-974
  • 11 Chen WJ, Wu N, Zhou JL, Lin GL, Qiu HZ. Full-thickness excision using transanal endoscopic microsurgery for treatment of rectal neuroendocrine tumors. World J Gastroenterol 2015; 21 (30) 9142-9149
  • 12 Kumar AS, Sidani SM, Kolli K , et al. Transanal endoscopic microsurgery for rectal carcinoids: the largest reported United States experience. Colorectal Dis 2012; 14 (5) 562-566
  • 13 Bochove-Overgaauw DM, Beerlage HP, Bosscha K, Gelderman WA. Transanal endoscopic microsurgery for correction of rectourethral fistulae. J Endourol 2006; 20 (12) 1087-1090
  • 14 Duek SD, Gilshtein H, Khoury W. Transanal endoscopic microsurgery: also for the treatment of retrorectal tumors. Minim Invasive Ther Allied Technol 2014; 23 (1) 28-31
  • 15 Pigalarga R, Patel NM, Rezac C. Transanal endoscopic microsurgery-assisted rectal advancement flap is a viable option for iatrogenic rectourethral fistula repair: a case report. Tech Coloproctol 2011; 15 (2) 209-211
  • 16 Serra-Aracil X, Mora-Lopez L, Alcantara-Moral M, Corredera-Cantarin C, Gomez-Diaz C, Navarro-Soto S. Atypical indications for transanal endoscopic microsurgery to avoid major surgery. Tech Coloproctol 2014; 18 (2) 157-164
  • 17 Christoforidis D, Cho HM, Dixon MR, Mellgren AF, Madoff RD, Finne CO. Transanal endoscopic microsurgery versus conventional transanal excision for patients with early rectal cancer. Ann Surg 2009; 249 (5) 776-782
  • 18 Moore JS, Cataldo PA, Osler T, Hyman NH. Transanal endoscopic microsurgery is more effective than traditional transanal excision for resection of rectal masses. Dis Colon Rectum 2008; 51 (7) 1026-1030 , discussion 1030–1031
  • 19 de Graaf EJ, Burger JW, van Ijsseldijk AL, Tetteroo GW, Dawson I, Hop WC. Transanal endoscopic microsurgery is superior to transanal excision of rectal adenomas. Colorectal Dis 2011; 13 (7) 762-767
  • 20 Bretagnol F, Merrie A, George B, Warren BF, Mortensen NJ. Local excision of rectal tumours by transanal endoscopic microsurgery. Br J Surg 2007; 94 (5) 627-633
  • 21 de Graaf EJ, Doornebosch PG, Tetteroo GW, Geldof H, Hop WC. Transanal endoscopic microsurgery is feasible for adenomas throughout the entire rectum: a prospective study. Dis Colon Rectum 2009; 52 (6) 1107-1113
  • 22 Guerrieri M, Baldarelli M, de Sanctis A, Campagnacci R, Rimini M, Lezoche E. Treatment of rectal adenomas by transanal endoscopic microsurgery: 15 years' experience. Surg Endosc 2010; 24 (2) 445-449
  • 23 Ramirez JM, Aguilella V, Gracia JA , et al. Local full-thickness excision as first line treatment for sessile rectal adenomas: long-term results. Ann Surg 2009; 249 (2) 225-228
  • 24 Said S, Stippel D. Transanal endoscopic microsurgery in large, sessile adenomas of the rectum. A 10-year experience. Surg Endosc 1995; 9 (10) 1106-1112
  • 25 Tsai BM, Finne CO, Nordenstam JF, Christoforidis D, Madoff RD, Mellgren A. Transanal endoscopic microsurgery resection of rectal tumors: outcomes and recommendations. Dis Colon Rectum 2010; 53 (1) 16-23
  • 26 Clancy C, Burke JP, Albert MR, O'Connell PR, Winter DC. Transanal endoscopic microsurgery versus standard transanal excision for the removal of rectal neoplasms: a systematic review and meta-analysis. Dis Colon Rectum 2015; 58 (2) 254-261
  • 27 van Gijn W, Marijnen CA, Nagtegaal ID , et al; Dutch Colorectal Cancer Group. Preoperative radiotherapy combined with total mesorectal excision for resectable rectal cancer: 12-year follow-up of the multicentre, randomised controlled TME trial. Lancet Oncol 2011; 12 (6) 575-582
  • 28 Peeters KC, van de Velde CJ, Leer JW , et al. Late side effects of short-course preoperative radiotherapy combined with total mesorectal excision for rectal cancer: increased bowel dysfunction in irradiated patients--a Dutch colorectal cancer group study. J Clin Oncol 2005; 23 (25) 6199-6206
  • 29 NCCN guidelines version 3.2015 rectal cancer. NCCN Clinical Practice Guidelines in Oncology. Web site: http://www.nccn.org/professionals/physician_gls/f_guidelines.asp#rectal . Updated 2015 . Accessed 09/07, 2015
  • 30 Arezzo A, Bianco F, Agresta F , et al; Italian Society of Colorectal Surgery. Practice parameters for early rectal cancer management: Italian Society of Colorectal Surgery (Società Italiana di Chirurgia Colo-Rettale; SICCR) guidelines. Tech Coloproctol 2015; 19 (10) 587-593
  • 31 Morino M, Risio M, Bach S , et al; European Association for Endoscopic Surgery; European Society of Coloproctology. Early rectal cancer: the European Association for Endoscopic Surgery (EAES) clinical consensus conference. Surg Endosc 2015; 29 (4) 755-773
  • 32 Cataldo PA. Local excision of rectal cancer. In: Beck D, Roberts P, Saclarides T, Senagore A, Stamos M, Wexner S, , eds. The ASCRS Textbook of Colon and Rectal Surgery. New York: Springer; 2011: 731
  • 33 Winde G, Nottberg H, Keller R, Schmid KW, Bünte H. Surgical cure for early rectal carcinomas (T1). Transanal endoscopic microsurgery vs. anterior resection. Dis Colon Rectum 1996; 39 (9) 969-976
  • 34 Kidane B, Chadi SA, Kanters S, Colquhoun PH, Ott MC. Local resection compared with radical resection in the treatment of T1N0M0 rectal adenocarcinoma: a systematic review and meta-analysis. Dis Colon Rectum 2015; 58 (1) 122-140
  • 35 Lu JY, Lin GL, Qiu HZ, Xiao Y, Wu B, Zhou JL. Comparison of transanal endoscopic microsurgery and total mesorectal excision in the treatment of T1 rectal cancer: A meta-analysis. PLoS One 2015; 10 (10) e0141427
  • 36 Baatrup G, Breum B, Qvist N , et al. Transanal endoscopic microsurgery in 143 consecutive patients with rectal adenocarcinoma: results from a Danish multicenter study. Colorectal Dis 2009; 11 (3) 270-275
  • 37 Lezoche G, Guerrieri M, Baldarelli M , et al. Transanal endoscopic microsurgery for 135 patients with small nonadvanced low rectal cancer (iT1-iT2, iN0): short- and long-term results. Surg Endosc 2011; 25 (4) 1222-1229
  • 38 Lezoche G, Baldarelli M, Guerrieri M , et al. A prospective randomized study with a 5-year minimum follow-up evaluation of transanal endoscopic microsurgery versus laparoscopic total mesorectal excision after neoadjuvant therapy. Surg Endosc 2008; 22 (2) 352-358
  • 39 Lezoche E, Guerrieri M, Paganini AM, Feliciotti F. Long-term results of patients with pT2 rectal cancer treated with radiotherapy and transanal endoscopic microsurgical excision. World J Surg 2002; 26 (9) 1170-1174
  • 40 Lezoche E, Guerrieri M, Paganini AM , et al. Transanal endoscopic versus total mesorectal laparoscopic resections of T2-N0 low rectal cancers after neoadjuvant treatment: a prospective randomized trial with a 3-years minimum follow-up period. Surg Endosc 2005; 19 (6) 751-756
  • 41 Lezoche E, Baldarelli M, Lezoche G, Paganini AM, Gesuita R, Guerrieri M. Randomized clinical trial of endoluminal locoregional resection versus laparoscopic total mesorectal excision for T2 rectal cancer after neoadjuvant therapy. Br J Surg 2012; 99 (9) 1211-1218
  • 42 Garcia-Aguilar J, Shi Q, Thomas Jr CR , et al. A phase II trial of neoadjuvant chemoradiation and local excision for T2N0 rectal cancer: preliminary results of the ACOSOG Z6041 trial. Ann Surg Oncol 2012; 19 (2) 384-391
  • 43 Verseveld M, de Graaf EJ, Verhoef C , et al; CARTS Study Group. Chemoradiation therapy for rectal cancer in the distal rectum followed by organ-sparing transanal endoscopic microsurgery (CARTS study). Br J Surg 2015; 102 (7) 853-860
  • 44 Bujko K, Richter P, Smith FM , et al. Preoperative radiotherapy and local excision of rectal cancer with immediate radical re-operation for poor responders: a prospective multicentre study. Radiother Oncol 2013; 106 (2) 198-205
  • 45 Perez RO, Habr-Gama A, São Julião GP , et al. Transanal endoscopic microsurgery (TEM) following neoadjuvant chemoradiation for rectal cancer: outcomes of salvage resection for local recurrence. Ann Surg Oncol 2016; 23 (4) 1143-1148
  • 46 Albert MR, Atallah SB, deBeche-Adams TC, Izfar S, Larach SW. Transanal minimally invasive surgery (TAMIS) for local excision of benign neoplasms and early-stage rectal cancer: efficacy and outcomes in the first 50 patients. Dis Colon Rectum 2013; 56 (3) 301-307
  • 47 Dafnis G, Påhlman L, Raab Y, Gustafsson UM, Graf W. Transanal endoscopic microsurgery: clinical and functional results. Colorectal Dis 2004; 6 (5) 336-342
  • 48 Mora López L, Serra Aracil X, Hermoso Bosch J, Rebasa P, Navarro Soto S. Study of anorectal function after transanal endoscopic surgery. Int J Surg 2015; 13: 142-147
  • 49 Cataldo PA, O'Brien S, Osler T. Transanal endoscopic microsurgery: a prospective evaluation of functional results. Dis Colon Rectum 2005; 48 (7) 1366-1371
  • 50 Allaix ME, Rebecchi F, Giaccone C, Mistrangelo M, Morino M. Long-term functional results and quality of life after transanal endoscopic microsurgery. Br J Surg 2011; 98 (11) 1635-1643
  • 51 Hompes R, Ashraf SQ, Gosselink MP , et al. Evaluation of quality of life and function at 1 year after transanal endoscopic microsurgery. Colorectal Dis 2015; 17 (2) O54-O61
  • 52 Planting A, Phang PT, Raval MJ, Brown CJ. Transanal endoscopic microsurgery: impact on fecal incontinence and quality of life. Can J Surg 2013; 56 (4) 243-248
  • 53 Barendse RM, Oors JM, de Graaf EJ , et al. The effect of endoscopic mucosal resection and transanal endoscopic microsurgery on anorectal function. Colorectal Dis 2013; 15 (9) e534-e541
  • 54 Karakayali FY, Tezcaner T, Moray G. Anorectal function and outcomes after transanal minimally invasive surgery for rectal tumors. J Minim Access Surg 2015; 11 (4) 257-262
  • 55 Schiphorst AH, Langenhoff BS, Maring J, Pronk A, Zimmerman DD. Transanal minimally invasive surgery: initial experience and short-term functional results. Dis Colon Rectum 2014; 57 (8) 927-932
  • 56 Verseveld M, Barendse RM, Gosselink MP, Verhoef C, de Graaf EJ, Doornebosch PG. Transanal minimally invasive surgery: impact on quality of life and functional outcome. Surg Endosc 2016; 30 (3) 1184-1187
  • 57 Keller DS, Haas EM. Transanal minimally invasive surgery: state of the art. J Gastrointest Surg 2016; 20 (2) 463-469
  • 58 Saget A, Maggiori L, Petrucciani N, Ferron M, Panis Y. Is there a limit to transanal endoscopic surgery? A comparative study between standard and technically challenging indications among 168 consecutive patients. Colorectal Dis 2015; 17 (7) O155-O160
  • 59 Maslekar S, Pillinger SH, Sharma A, Taylor A, Monson JR. Cost analysis of transanal endoscopic microsurgery for rectal tumours. Colorectal Dis 2007; 9 (3) 229-234
  • 60 Farmer KC, Wale R, Winnett J, Cunningham I, Grossberg P, Polglase A. Transanal endoscopic microsurgery: the first 50 cases. ANZ J Surg 2002; 72 (12) 854-856
  • 61 Barendse RM, Doornebosch PG, Bemelman WA, Fockens P, Dekker E, de Graaf EJ. Transanal employment of single access ports is feasible for rectal surgery. Ann Surg 2012; 256 (6) 1030-1033
  • 62 Heintz A, Mörschel M, Junginger T. Comparison of results after transanal endoscopic microsurgery and radical resection for T1 carcinoma of the rectum. Surg Endosc 1998; 12 (9) 1145-1148
  • 63 Lee W, Lee D, Choi S, Chun H. Transanal endoscopic microsurgery and radical surgery for T1 and T2 rectal cancer. Surg Endosc 2003; 17 (8) 1283-1287
  • 64 Floyd ND, Saclarides TJ. Transanal endoscopic microsurgical resection of pT1 rectal tumors. Dis Colon Rectum 2006; 49 (2) 164-168
  • 65 Ganai S, Kanumuri P, Rao RS, Alexander AI. Local recurrence after transanal endoscopic microsurgery for rectal polyps and early cancers. Ann Surg Oncol 2006; 13 (4) 547-556
  • 66 Jeong WK, Park JW, Choi HS, Chang HJ, Jeong SY. Transanal endoscopic microsurgery for rectal tumors: experience at Korea's National Cancer Center. Surg Endosc 2009; 23 (11) 2575-2579
  • 67 Allaix ME, Arezzo A, Caldart M, Festa F, Morino M. Transanal endoscopic microsurgery for rectal neoplasms: experience of 300 consecutive cases. Dis Colon Rectum 2009; 52 (11) 1831-1836
  • 68 De Graaf EJ, Doornebosch PG, Tollenaar RA , et al. Transanal endoscopic microsurgery versus total mesorectal excision of T1 rectal adenocarcinomas with curative intention. Eur J Surg Oncol 2009; 35 (12) 1280-1285
  • 69 Palma P, Horisberger K, Joos A, Rothenhoefer S, Willeke F, Post S. Local excision of early rectal cancer: is transanal endoscopic microsurgery an alternative to radical surgery?. Rev Esp Enferm Dig 2009; 101 (3) 172-178
  • 70 Doornebosch PG, Ferenschild FT, de Wilt JH, Dawson I, Tetteroo GW, de Graaf EJ. Treatment of recurrence after transanal endoscopic microsurgery (TEM) for T1 rectal cancer. Dis Colon Rectum 2010; 53 (9) 1234-1239
  • 71 Steinhagen E, Chang G, Guillem JG. Initial experience with transanal endoscopic microsurgery: the need for understanding the limitations. J Gastrointest Surg 2011; 15 (6) 958-962
  • 72 Ramirez JM, Aguilella V, Valencia J , et al. Transanal endoscopic microsurgery for rectal cancer. Long-term oncologic results. Int J Colorectal Dis 2011; 26 (4) 437-443
  • 73 Stipa F, Giaccaglia V, Burza A. Management and outcome of local recurrence following transanal endoscopic microsurgery for rectal cancer. Dis Colon Rectum 2012; 55 (3) 262-269
  • 74 Endreseth BH, Wibe A, Svinsås M, Mårvik R, Myrvold HE. Postoperative morbidity and recurrence after local excision of rectal adenomas and rectal cancer by transanal endoscopic microsurgery. Colorectal Dis 2005; 7 (2) 133-137
  • 75 Amann M, Burghardt J, Stratz C, Buess GF, Modabber A. Transanal endoscopic microsurgery in treatment of small rectal T1 high-risk, T2 and T3 carcinomas combined with radiochemotherapy. Eur Surg 2015; 47 (5) 226-237