• Michael Goldenshluger, Yaara Gutman, Aviad Katz, Gal Schtrechman, Gal Westrich, Aviram Nissan, and Lior Segev.
• Department of General and Oncological Surgery C, Sheba Medical Center, affiliated with Sackler Faculty of Medicine, Tel Aviv University, Tel Hashomer, Israel.
• Isr Med Assoc J. 2020 Jul 1; 7 (22): 360-364.

BackgroundTransanal minimally invasive surgery (TAMIS) is a single port access platform used for full thickness local excision of rectal lesions. It is an appealing alternative to a radical resection of rectum that often can cause a significant bowel dysfunction described as low anterior resection syndrome (LARS). LARS is evaluated using a validated score. Functional outcomes of patients undergoing TAMIS has not yet been evaluated using the LARS score.ObjectivesTo evaluate long-term bowel function in patients who underwent TAMIS.MethodsIn this case series, all patients who underwent TAMIS in a single tertiary institute between 2011 and 2017 were retrospectively reviewed. We evaluated bowel function using the LARS score questionnaire through telephone interviews.ResultsThe study consisted of 23 patients, average age of 67 ± 6.98 year; 72% were male. The median follow-up from the time of surgery was 5 years. Six patients (26.08%) had malignant type lesions. The average height of the lesion from the anal verge was 7.4 cm. The average size of the specimen was 4 cm. The total LARS score revealed that 17 patients (73.91%) had no definitive LAR syndrome following the surgery. Four patients (17.39%) fit the description of minor LARS and only two (8.69%) presented with major LARS.ConclusionsTAMIS provides relatively good long-term functional outcomes in terms of bowel function. Further randomized studies with larger cohorts are still needed to better evaluate the outcomes.

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