Transanal Minimally Invasive Surgery in the Treatment of Large Polyps and Early Rectal Carcinoma

Abstract

Transanal minimally invasive surgery is a relatively new diagnostic and therapeutic approach for removing pathological lesions localized in the mid-rectum and its distal third. The availability of laparoscopic equipment and its low cost made this procedure dominant over others. A total of 12 patients underwent afore-mentioned procedure at the Clinical Hospital Center of Zemun. Patients were diagnosed with either benign adenomas or early rectal carcinoma, all verified by histopathological analysis, which could not be removed using endoscopic methods. During the research, we examined the procedure’s feasibility, the margin’s negativity, length of hospital stays, and early complications. The average distance of lesions from the anocutaneous line was 8.1 cm. Mucosectomy was most often performed, followed by full-thickness resection of the rectal wall and resection of the rectal wall with part of the mesorectal tissue. The average size of polypoid lesions was 3 cm. We had positive margins in only one case. The postoperative hospital stay was average 1.8 days. Regarding early postoperative complications, we had one case of postoperative bleeding, which was treated with endoscopic hemostasis. All transanal resection techniques aim to obtain adequate, negative margins of resected pathological lesion. A high percentage of patients with negative margins and a low level of postoperative complications make this procedure applicable in modern practice. This procedure has proven to be a safe, effective and reproducible technique. With the development of the surgical technique, it will be increasingly used to perform more complex colorectal operations in our center.