TY - JOUR
TI - The Role of TAMIS (Transanal Minimally Invasive Surgery) in the Management of Advanced Rectal Cancer–One Shared Story of Three Exceptional Cases
AU - Giannoulopoulos, D.
AU - Nastos, C.
AU - Gavriatopoulou, M.
AU - Vezakis, A.
AU - Dellaportas, D.
AU - Sotirova, I.
AU - Giokas, G.
AU - Polymeneas, G.
AU - Theodosopoulos, T.
JO - Journal of Investigative Surgery
PY - 2019
VL - 32
TODO - 4
SP - 371-376
PB - Taylor and Francis Ltd.
SN - 0894-1939, 1521-0553
TODO - 10.1080/08941939.2017.1418462
TODO - capecitabine plus oxaliplatin;  carcinoembryonic antigen, advanced cancer;  aged;  Article;  case report;  Caucasian;  chemoradiotherapy;  clinical article;  clinical outcome;  colonoscopy;  colostomy;  comorbidity;  digital rectal examination;  endoscopic ultrasonography;  female;  human;  local excision;  lung embolism;  male;  minimally invasive surgery;  multiple cycle treatment;  nuclear magnetic resonance imaging;  priority journal;  rectum anterior resection;  rectum biopsy;  rectum carcinoma;  rectum hemorrhage;  remission;  transanal minimally invasive surgery;  very elderly;  anal canal;  minimally invasive surgery;  quality of life;  rectum tumor;  transanal endoscopic surgery;  tumor recurrence, Anal Canal;  Humans;  Minimally Invasive Surgical Procedures;  Neoplasm Recurrence, Local;  Quality of Life;  Rectal Neoplasms;  Transanal Endoscopic Surgery
TODO - Purpose of the study: The current gold standard for contemporary treatment of rectal cancer is total mesorectal excision (TME), achieving excellent local disease control and low recurrence rates. However, TME may be associated with postoperative mortality and quality of life deterioration. Therefore, the need to develop less radical treatment strategies has emerged. Transanal minimally invasive surgery (TAMIS) is currently indicated only for early rectal cancer. However, local excision following chemoradiation has yielded promising clinical outcomes in selected cases with more advanced disease. Materials and methods: We describe three cases of patients with advanced rectal cancer, who were managed with TAMIS, either due to patients' unwillingness to tolerate permanent colostomy or due to significant comorbidities. Results: Two of the three patients who also received adjuvant chemoradiation are still in remission for 18 and 15 months respectively. The third patient died early after hospital release due to unrelated causes. Conclusions: Local excision utilizing minimally invasive techniques, alongside with chemoradiotherapy and close follow up can be a viable alternative in carefully selected rectal cancer patients with advanced disease who deny permanent colostomy or are ineligible for major operations. © 2018, Copyright © 2018 Taylor & Francis Group, LLC.
ER -