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is justified by the possibility of infection or postoperative histopathological findings, which accounts for only 6.66%,
perforation. In one study, in 25% of patients, the defect was significantly lower than in the TAMIS group. This demon-
left to heal without closure due to the extent of the lesion . strates that both TAE and TAMIS can achieve adequate sta-
23
In these cases, the polypoid changes had spread to more ging of patients with polypoid and early malignant lesions
than 50% of the rectal wall, so closing the defect would lead of the rectum.
to stenosis of the rectal lumen. No complications were re-
corded in any case 23, 24 . We also did not encounter complica- The postoperative hospitalization period is shorter in
tions due to the non-closure of the mucosal and rectal wall TAE compared to TAMIS (1.3 days versus 1.8 days). We did
defect in our study. not encounter any serious postoperative complications in
either group. In one case, we had postoperative bleeding,
Analysis of histopathological specimens preoperatively which was managed with endoscopic hemostasis.
and postoperatively reveals some discrepancies. This phe-
nomenon is also documented in the global literature, whe- The low frequency of postoperative complications, even
re a certain percentage of patients, which can range up to in our small patient series, justifies the introduction of the
40%, were either overestimated or underestimated histo- TAMIS procedure into daily practice for the surgical mana-
pathologically preoperatively 25, 26 . gement of large endoscopically unresectable rectal polyps
located high in the rectum, in line with other studies 27, 28 . The
In our study, in the TAMIS group, two patients were simultaneous low percentage of recurrences and malignant
histopathologically underestimated preoperatively, while alterations after polyp resection, according to the literature,
two were overestimated. 33.3% of patients had incorre- only confirms our assertion .
29
ct preoperative histopathological diagnoses, which were
corrected only by the final histopathological analysis of the
entire specimen. In the TAE group, we had only one patient
with a discrepancy between preoperative and postoperative

Conclusion

Radical local resections, TAE, and TAMIS are sustainable alternatives to radical surgical resection of
the rectum for polypoid changes and early T1 rectal carcinomas. The advantages of these techniques
lie in faster patient recovery, shorter hospital stays, and fewer complications. These techniques have
proven to be safe, effective, and repeatable. TAE should be applied to changes in the distal rectum,
while TAMIS should be used for lesions in the proximal and middle thirds. We believe that with the
development of surgical techniques, TAE and TAMIS will increasingly be used in performing more
complex colorectal surgeries.

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ORIGINAL PAPER Galenika Medical Journal, 2024; 3(9):11-18. 17