|[Transanal endoscopic microsurgery (tem) and transanal minimally invasive surgery (tamis) for the treatment of rectal lesions]|
|Tapia-López E, Pichon-Riviere A, Augustovski F, García Martí S, Alcaraz A, Bardach A, Ciapponi A|
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Tapia-López E, Pichon-Riviere A, Augustovski F, García Martí S, Alcaraz A, Bardach A, Ciapponi A. [Transanal endoscopic microsurgery (tem) and transanal minimally invasive surgery (tamis) for the treatment of rectal lesions] Buenos Aires: Institute for Clinical Effectiveness and Health Policy (IECS). Documentos de Evaluación de Tecnologías Sanitarias, Informe de Respuesta Rapida No 524. 2017
Evidence of moderate quality suggests that in patients with Stage 0 and I rectal cancer, where a less invasive treatment is considered, transanal endoscopic microsurgery (TEM) might result in a lower rate of local recurrence and achieve a higher rate of resection with negative margins than conventional transanal resection, although it might result in higher rates of local recurrence when compared with rectal resection with total mesorectal excision through the abdomen. In patients with rectal adenoma, transanal endoscopic microsurgery might result in a lower early recurrence when compared with endoscopic mucosal resection, although it might be associated to a higher rate of intra and postoperative events. As regards transanal minimally invasive surgery (TAMIS), very low quality evidence was found and it does not allow drawing conclusions on its efficacy and safety. No evidence comparing transanal endoscopic microsurgery with transanal minimally invasive surgery was found for the treatment of rectal lesions. The clinical practice guidelines consider transanal endoscopic microsurgery as an alternative surgical treatment for early rectal cancer and with no metastasis. Transanal minimally invasive surgery is not mentioned. The private health sponsors consulted do not consider coverage of transanal endoscopic surgery in benign rectal tumors and in T1 and low-risk rectal cancer, mainly.
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Humans; Minimally Invasive Surgical Procedures; Rectal Neoplasms; Transanal Endoscopic Microsurgery
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Institute for Clinical Effectiveness and Health Policy, Viamonte 2146 – 3 Piso, C1056ABH Ciudad de Buenos Aires, Argentina Tel: +54 11 49 66 00 82 Fax:+54 11 49 53 40 58 Email: firstname.lastname@example.org
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