Transanal minimally invasive surgery using laparoscopic instruments of the rectum: A review

Table 3 Postoperative Complications and it’s treatment

Ref.	Pts, n (%)	Complications, n (%)	Type of complications, n (%)	Reoperation	Re-admission	Conversion	Treatment of PPC
Van den Boezem et al[55], 2011	12	1	Bleeding (1)	0	0	TAE (2)	0
Hompes et al[32], 2014	14	2	Fever (1); Bleeding (1)	Positive for deep margin (1)	0	CAD fail (1); TEM assist (1)	0
Barendse et al[57], 2012	15	2	Pneumoscrotum (1); Hemorrhage (1)	0	Bleeding (1)	TEM (2)	0
Ragupathi et al[59], 2012	20	1	Abscess (1)	Inadequate surgical margin within 1mm (2)	0	0	0
Albert et al[30], 2013	50	4	Bleeding (1); Scrotal emphysema (1); PPC (1); COPD exacerbation (1)	0	Bleeding (1)	0	TAMIS repair (1)
Sevá-Pereira et al[61], 2014	5	1	Partial dehiscence of the suture line (1)		0	L-LAR (1)
McLemore et al[27], 2014	32	8	FI (3); UTI (1); CD diarrhea (1); Afib (1); Rectal stenosis (1); Bleeding (1)	0	Bleeding (1)	TAE (1)	0
Schiphorst et al[53], 2014	37	6	Rectal perforation (2); Heamorrhage (2); Abscess (1); Rectal stricture (1)	Pelvic abscess (1)	Bleeding (3); Pelvic abscess (1)	L-AR (1)	L-AR (1). Pelvic abscess drainage (1)
Lee and Lee[28], 2014	25	1	POUR (1)	0	0	0	0
Hahnloser et al[33], 2015	75	21	Local infection (6); Postoperative bleeding (5); Intraoperative bleeding (3); Penetrate peritoneal cavity (3); Pneumoscrotum (3); UTI (2); POUR (2)	Rectal perforation (1)	NA	TAMIS + LR (2), Open laparotomy (1)	TAMIS + LR (2), Open laparotomy (1)
Gill et al[62], 2015	32	16	Bleeding (4); Diarrhea (4); POUR (3); Perianal pain (2); Ulceration (4); Hypovolemia (1); Rectal abscess (1); Aspiration pneumonia (1); FI (1)	Rectal perforation (1)	Aspiration penumoia (1); Rectal abcess (1)	TEM (1)	0
Quaresima et al[63], 2016	31	8	Penetrate peritoneal cavity (5); UTI (1); Subcutaneous emphysema (1); Hemorrhoidal thrombosis (1)	0	0	TAE (4)	TAMIS repair (4); TAE (1)
Keller et al[35], 2016	75	3	Bleeding (1); Rectal stricture (1); Rectovaginal fistula (1)	0	Rectal bleeding (1)	TAMIS + LR (2), DS (1), Diagnostic laparoscopy (1)	TAMIS + LR (1); TAMIS + DS (1)
Sumrien et al[43], 2016	28	10	POUR (6); Bleeding (1); PPC (1); Stricture (1); Fever (1)	Bleeding (1)	Rectal bleeding (1)	L-AR (2), O-AR (1), Endoscopic debulking (1)	TAMIS repair (1)
Verseveld et al[52], 2016	24	2	Bleeding (2)	Re-bleeding (1)	1	0	NA
Melin et al[64], 2016	29	3	Bleeding (1); POUR (1); PPC (1)	Bleeding (1), Resudual rectal polyp (1)	0	0	TAMIS repair (1)
Mege et al[65], 2017	33	4	NA	NA	NA	NA	2
Lee et al[24], 2018	200	31	Intraoperative complications (8); Bleeding (9); POUR (4); Scrotal or subcutaneous emphysema (3) Mild fecal incontinence (2); Self-limiting fever (2); Perianal pain (2); Perirectal inflammation (1); DVT (1); Heparin-induced thrombocytopenia (1); Rectovaginal fistula (1); UTI (1); Non-healing rectal wound (1)	DS for nonhealing wound (1)	Nonhealing rectal wound (1); Perirectal inflammation (1), Rectovaginal fistula (1)	TAMIS + LR (4)	TAMIS repair (4); TAMIS + LR (4)
García-Flórez et al[66], 2017	32	13	Fever (3); Hematuria (3); Rectal bleeding (3); PPC (2); Purulent peritonitis (1); Stenosis (1)	1	1	0	Transanal repair (2)
Caycedo-Marulanda et al[44], 2017	50	13	Bleeding (4); UTI (1); Suture line leak (1); POUR (1); PPC (5); Anal structure (1)	Penetrate peritoneal cavity (1)	Bleeding (4)	Hybrid (3)	Transanal repair (5)
Clermonts et al[67], 2017	42	6	Hemorrhage (4); Abscess (1); Rectal stricture (1)	Pelvic abscess (1)	4	0	0
Lee et al[42], 2017	181	16	Bleeding (4); Local infection (6); POUR (2); Complication requiring operation (2)	2	NA	LR (2); DS (1)	TAMIS repair (4), LR (2)
Lee et al[68], 2017	35	1	Suture line dehiscence (1)	0	0	0	0
Clermonts et al[67], 2017	37	4	Bleeding (3); Abscess (1)	Pelvic abscess (1)	4	0	0
Llano et al[71], 2019	27	6	PPC (2); Rectal bleeding (1); POUR (1); Advanced cancer (1); Stenosis (1)	0	0	LR (1)	TAMIS repair (1); LR (1)
Westrich et al[72], 2019	38	8	Fever (4); Bleeding (2); PPC (1); Major complication (1)	Rectal perforation (1)	Rectal perforation (2), bleeding (2)	0	TAMIS repair (1)
Van den Eynde et al[73], 2019	68	19	Bleeding (1); Complications ≥ grade 3 (1)	Bleeding (5)	3	NA	NA
Lee et al[17], 2019	21	2	POUR (1); PPC (1)	0	0	LR (1)	LR (1)
Abutaka et al[74], 2020	17	3	Bleeding (1); PPC (2)	0	0	LR (1)	TAMIS repair (1); LR (1)
Kang et al[45], 2020	30	4	Diarrhea (2); FI (1); Fluid collection (1)	0	0	TAE (2)	0
Goldenshluger et al[50], 2020	23	3	Bleeding (1); Fever (1)	0	0	0	0

TAMIS: Transanal minimally invasive surgery; Afib: Atrial fibrillation; FI:Fecal incontinence; UTI: Urinary tract infection; DVT: Deep vein thrombosis; CD: Clostrium difficle; COPD: Chronic obstructive pulmonary disease; POUR: Postoperative urinary retention; PPC: Penetrate peritoneal cavity; -: Not available; LR: Laparoscopic repair; DS: Diverting stoma; TAE: Conventional transanal excision; L-AR: Laparoscopic anterior resection; O-AR: Open anterior resection.