Transanal minimally invasive surgery for rectal neuroendocrine tumors
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and Other Interventional Techniques
Transanal minimally invasive surgery for rectal neuroendocrine tumors Shigeoki Hayashi1 · Tadatoshi Takayama1 · Masahito Ikarashi1 · Ken Hagiwara1 · Yoritaka Matsuno1 · Takeki Suzuki2 Received: 3 July 2020 / Accepted: 15 November 2020 © Springer Science+Business Media, LLC, part of Springer Nature 2020
Abstract Background There is no literature that mainly searched for rectal neuroendocrine tumor (rNET) using transanal minimal invasive surgery (TAMIS). We report our clinical experiences of TAMIS for rectal neuroendocrine tumors to evaluate the feasibility and safety. Methods Between December 2010 and March 2020, the 25 consecutive patients with rectal neoplasma underwent the TAMIS procedure performed by single laparoscopic surgeon at the two hospitals. Of these, ten patients with rectal neuroendocrine tumors were reviewed retrospectively. The full-thickness excision down to the outer fatty tissues was completed using TAMIS technique. Clinicopathological findings, perioperative and postoperative complications were recorded. Results TAMIS for small rNET was successfully completed in all cases. There were seven cases with a tumor size of less than 10 mm, and three cases with a tumor size between 10 and 15 mm. Six patients underwent the primary tumor excision; the remaining four patients underwent resection for the scar after endoscopic procedure. The median surgical duration was 80.5 (53–124) minutes and the median blood loss was 1 (1–12) ml. All removed tumors in the 6 primary excisions were diagnosed as neuroendocrine tumor G1. The margins of specimens were completely free in all cases. Among the four patients after endoscopic procedure, all had no histological evidence of residual tumor. The median length of hospital stay was 7 days postoperatively. There was no post-operative mortality or severe complication. The median length of observation was 54 months. No recurrence, no local or distant metastasis and no mortality of all patients were observed. Conclusions TAMIS is safety and feasible procedure for small rNET. Further experience and clinical trials are needed to fully define the advantages, disadvantages, and indications of TAMIS for rNET. Keywords Transanal minimal invasive surgery · Rectal neuroendocrine tumors · SILSTEM According to the Surveillance, Epidemiology and End Results (SEER) database, gastrointestinal neuroendocrine tumors have increased from 1975 to 2008 [1]. The incidence of rectal neuroendocrine tumors (NET) is approximately 1 per 100,000 of the population per year with the majority of tumors (80–90%) being
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