Transanal minimally invasive rectal resection for deep endometriosis: a promising technique

Research output: Contribution to journalArticleAcademicpeer-review

Abstract

Aim: Surgical management of patients with deep endometriosis (DE) of the rectum is difficult. Inflammation and subsequent adhesions due to DE impede access to the lower pelvis and may lead to complications during laparoscopic low anterior resection (LAR). Transanal minimally invasive surgery (TAMIS) is an alternative to an abdominal approach with potential advantages. The aim of this study was to provide a description of the TAMIS technique and to present the perioperative results of TAMIS and of conventional LAR in patients with DE. Method: A prospective consecutive cohort of patients undergoing rectal resection for DE had either conventional laparoscopic LAR or TAMIS rectal excision. Pre-, intra- and postoperative parameters, such as patient symptomatology, operating time and postoperative complications were compared between the groups. Quality of life was assessed using the EORTC-QLQ-29/30 questionnaires. Results: Between May 2014 and March 2016 a total of 11 rectal resections were performed, including five TAMIS procedures. No differences were found in the pre-, intra- or postoperative parameters. Two major complications occurred after conventional LAR and none after TAMIS. No differences in quality of life were found between the groups. Conclusion: Transanal minimally invasive surgery for DE of the rectum is feasible. Potential advantages include better surgical access to the pelvis, possibly fewer complications than LAR and no extraction incision with no difference in quality of life. Larger prospective studies are required to compare TAMIS with conventional rectal resection.

Original languageEnglish
Pages (from-to)576-581
Number of pages6
JournalColorectal Disease
Volume19
Issue number6
DOIs
Publication statusPublished - 1 Jun 2017

Cite this

@article{1fac84195ea949bd89519596398943ab,
title = "Transanal minimally invasive rectal resection for deep endometriosis: a promising technique",
abstract = "Aim: Surgical management of patients with deep endometriosis (DE) of the rectum is difficult. Inflammation and subsequent adhesions due to DE impede access to the lower pelvis and may lead to complications during laparoscopic low anterior resection (LAR). Transanal minimally invasive surgery (TAMIS) is an alternative to an abdominal approach with potential advantages. The aim of this study was to provide a description of the TAMIS technique and to present the perioperative results of TAMIS and of conventional LAR in patients with DE. Method: A prospective consecutive cohort of patients undergoing rectal resection for DE had either conventional laparoscopic LAR or TAMIS rectal excision. Pre-, intra- and postoperative parameters, such as patient symptomatology, operating time and postoperative complications were compared between the groups. Quality of life was assessed using the EORTC-QLQ-29/30 questionnaires. Results: Between May 2014 and March 2016 a total of 11 rectal resections were performed, including five TAMIS procedures. No differences were found in the pre-, intra- or postoperative parameters. Two major complications occurred after conventional LAR and none after TAMIS. No differences in quality of life were found between the groups. Conclusion: Transanal minimally invasive surgery for DE of the rectum is feasible. Potential advantages include better surgical access to the pelvis, possibly fewer complications than LAR and no extraction incision with no difference in quality of life. Larger prospective studies are required to compare TAMIS with conventional rectal resection.",
keywords = "Endometriosis, rectum, TAMIS",
author = "Vlek, {S. L.} and Lier, {M. C.I.} and Koedam, {T. W.A.} and I. Melgers and Dekker, {J. J.M.L.} and Bonjer, {J. H.} and V. Mijatovic and Tuynman, {J. B.}",
year = "2017",
month = "6",
day = "1",
doi = "10.1111/codi.13569",
language = "English",
volume = "19",
pages = "576--581",
journal = "Colorectal Disease",
issn = "1462-8910",
publisher = "Wiley-Blackwell",
number = "6",

}

Transanal minimally invasive rectal resection for deep endometriosis : a promising technique. / Vlek, S. L.; Lier, M. C.I.; Koedam, T. W.A.; Melgers, I.; Dekker, J. J.M.L.; Bonjer, J. H.; Mijatovic, V.; Tuynman, J. B.

In: Colorectal Disease, Vol. 19, No. 6, 01.06.2017, p. 576-581.

Research output: Contribution to journalArticleAcademicpeer-review

TY - JOUR

T1 - Transanal minimally invasive rectal resection for deep endometriosis

T2 - a promising technique

AU - Vlek, S. L.

AU - Lier, M. C.I.

AU - Koedam, T. W.A.

AU - Melgers, I.

AU - Dekker, J. J.M.L.

AU - Bonjer, J. H.

AU - Mijatovic, V.

AU - Tuynman, J. B.

PY - 2017/6/1

Y1 - 2017/6/1

N2 - Aim: Surgical management of patients with deep endometriosis (DE) of the rectum is difficult. Inflammation and subsequent adhesions due to DE impede access to the lower pelvis and may lead to complications during laparoscopic low anterior resection (LAR). Transanal minimally invasive surgery (TAMIS) is an alternative to an abdominal approach with potential advantages. The aim of this study was to provide a description of the TAMIS technique and to present the perioperative results of TAMIS and of conventional LAR in patients with DE. Method: A prospective consecutive cohort of patients undergoing rectal resection for DE had either conventional laparoscopic LAR or TAMIS rectal excision. Pre-, intra- and postoperative parameters, such as patient symptomatology, operating time and postoperative complications were compared between the groups. Quality of life was assessed using the EORTC-QLQ-29/30 questionnaires. Results: Between May 2014 and March 2016 a total of 11 rectal resections were performed, including five TAMIS procedures. No differences were found in the pre-, intra- or postoperative parameters. Two major complications occurred after conventional LAR and none after TAMIS. No differences in quality of life were found between the groups. Conclusion: Transanal minimally invasive surgery for DE of the rectum is feasible. Potential advantages include better surgical access to the pelvis, possibly fewer complications than LAR and no extraction incision with no difference in quality of life. Larger prospective studies are required to compare TAMIS with conventional rectal resection.

AB - Aim: Surgical management of patients with deep endometriosis (DE) of the rectum is difficult. Inflammation and subsequent adhesions due to DE impede access to the lower pelvis and may lead to complications during laparoscopic low anterior resection (LAR). Transanal minimally invasive surgery (TAMIS) is an alternative to an abdominal approach with potential advantages. The aim of this study was to provide a description of the TAMIS technique and to present the perioperative results of TAMIS and of conventional LAR in patients with DE. Method: A prospective consecutive cohort of patients undergoing rectal resection for DE had either conventional laparoscopic LAR or TAMIS rectal excision. Pre-, intra- and postoperative parameters, such as patient symptomatology, operating time and postoperative complications were compared between the groups. Quality of life was assessed using the EORTC-QLQ-29/30 questionnaires. Results: Between May 2014 and March 2016 a total of 11 rectal resections were performed, including five TAMIS procedures. No differences were found in the pre-, intra- or postoperative parameters. Two major complications occurred after conventional LAR and none after TAMIS. No differences in quality of life were found between the groups. Conclusion: Transanal minimally invasive surgery for DE of the rectum is feasible. Potential advantages include better surgical access to the pelvis, possibly fewer complications than LAR and no extraction incision with no difference in quality of life. Larger prospective studies are required to compare TAMIS with conventional rectal resection.

KW - Endometriosis

KW - rectum

KW - TAMIS

UR - http://www.scopus.com/inward/record.url?scp=85020094778&partnerID=8YFLogxK

U2 - 10.1111/codi.13569

DO - 10.1111/codi.13569

M3 - Article

VL - 19

SP - 576

EP - 581

JO - Colorectal Disease

JF - Colorectal Disease

SN - 1462-8910

IS - 6

ER -