Transanal endoscopic and robot-assisted microsurgery for rectal tumors

OBJECTIVE: To analyze the results of transanal endoscopic and robotic microsurgery for rectal neoplasms. MATERIAL AND METHODS: A retrospective cohort study enrolled 84 patients. We considered clinical and anamnestic data, anatomical characteristics of tumors, intraoperative and histological data. Postoperative complications, data on disease progression and recurrence were analyzed. RESULTS: Transanal endoscopic surgery was performed in 82 patients; da Vinci Xi robotic complex was used in 2 patients. In 2% of patients, intraoperative complication occurred (full-thickness rectal wall defect with penetration into abdominal cavity). Postoperative complications were observed in 10% of patients: Clavien-Dindo class I - 1%, class IIIB - 7%, class V - 1%. Progression of cancer was observed in 13% of patients with malignant neoplasms. Local recurrence was observed in 4% of patients with benign neoplasms. CONCLUSION: Transanal microsurgery, including robotic microsurgery, is effective for rectal tumors. Further research is required to clarify the indications for this treatment option. Patients need for long-term postoperative follow-up regarding complications and recurrence of disease.