ArticleSurgical endoscopy2018
Establishing the learning curve of transanal minimally invasive surgery for local excision of rectal neoplasms.
Article in Surgical endoscopy, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 25 papers, 4 of them syntheses that pooled it.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
25 citing papers in PubMed, 4 syntheses or guidelines pooled it, 60 citations in OpenAlex.
- Trans‑anal minimally invasive surgery (TAMIS) versus rigid platforms for local excision of early rectal cancer: a systematic review and meta-analysis of the literature.Surgical endoscopy · 2024Pooled it
- P338: summarizing measures of proficiency in transanal total mesorectal excision-a systematic review.Surgical endoscopy · 2021Pooled it
- Should the rectal defect be sutured following TEMS/TAMIS carried out for neoplastic rectal lesions? A meta-analysis.Annals of the Royal College of Surgeons of England · 2020Pooled it
- Comparison of the transanal surgical techniques for local excision of rectal tumors: a network meta-analysis.International journal of colorectal disease · 2020Pooled it
- Learning curve of transanal minimally invasive surgery for rectal neoplasm.Frontiers in oncology · 2025Article
- Solitary fibrous tumor within the mesorectum: literature review based on a case report of resection by transanal minimally invasive surgery (TAMIS).International journal of colorectal disease · 2024Review
- Effect of virtual reality training to enhance laparoscopic assistance skills.BMC medical education · 2024Article
- Surgical Techniques for Transanal Local Excision for Early Rectal Cancer.Ewha medical journal · 2023Review
- A novel step-by-step training program for transanal endoscopic surgery.BMC medical education · 2023Article
- Short- and long-term outcomes in ypT2 rectal cancer patients after neoadjuvant therapy and local excision: a multicentre observational study.Techniques in coloproctology · 2023Observational
- Transanal versus laparoscopic total mesorectal excision: a comparative study of long-term oncological outcomes.Techniques in coloproctology · 2022Article
- Transanal Endoscopic Surgery: Who Should Be Doing This Procedure?Clinics in colon and rectal surgery · 2022Review
- Transanal Endoscopic Platforms: TAMIS versus Rigid Platforms: Pros and Cons.Clinics in colon and rectal surgery · 2022Review
- Current Status and Future of Robotic Surgery for Colorectal Cancer-An English Version.Journal of the anus, rectum and colon · 2022Review
- Management of early rectal cancer; current surgical options and future direction.World journal of gastrointestinal surgery · 2021Review
- Education and Training in Transanal Endoscopic Surgery and Transanal Total Mesorectal Excision.Clinics in colon and rectal surgery · 2021Review
- Current Challenges for Education and Training in Transanal Surgery.Clinics in colon and rectal surgery · 2021Review
- Can less be more? Organ preservation strategies in the management of rectal cancer.Current oncology (Toronto, Ont.) · 2019Review
- Long-term oncological results after transanal total mesorectal excision for rectal carcinoma.Techniques in coloproctology · 2019Article
- Laparoscopic transanal minimally invasive surgery (L-TAMIS) versus robotic TAMIS (R-TAMIS): short-term outcomes and costs of a comparative study.Surgical endoscopy · 2019Article
Corrections and comments
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Authors and funding
9 authors at 2 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
introductionTransanal minimally invasive surgery (TAMIS) is an endoscopic operating platform for local excision of rectal neoplasms. However, it may be technically demanding, and its learning curve has yet to be adequately defined. The objective of this study was to determine the number of TAMIS procedures for the local excision of rectal neoplasm required to reach proficiency. METHODS AND PROCEDURES: All TAMIS cases performed from 07/2009 to 12/2016 at a single high-volume tertiary care institution for local excision of benign and malignant rectal neoplasia were identified from a prospective database. A cumulative summation (CUSUM) analysis was performed to determine the number of cases required to reach proficiency. The main proficiency outcome was rate of margin positivity (R1 resection). The acceptable and unacceptable R1 rates were defined as the R1 rate of transanal endoscopic microsurgery (TEM-10%) and traditional transanal excision (TAE-26%), which was obtained from previously published meta-analyses. Comparisons of patient, tumor, and operative characteristics before and after TAMIS proficiency were performed.
resultsA total of 254 TAMIS procedures were included in this study. The overall R1 resection rate was 7%. The indication for TAMIS was malignancy in 57%. CUSUM analysis reported that TAMIS reached an acceptable R1 rate between 14 and 24 cases. Moving average plots also showed that the mean operative times stabilized by proficiency gain. The mean lesion size was larger after proficiency gain (3.0 cm (SD 1.5) vs. 2.3 cm (SD 1.3), p = 0.008). All other patient, tumor, and operative characteristics were similar before and after proficiency gain.
conclusionsTAMIS for local excision of rectal neoplasms is a complex procedure that requires a minimum of 14-24 cases to reach an acceptable R1 resection rate and lower operative duration.
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