Minimally Invasive Therapy & Allied Technologies最新文献

{"title":"Effects of dynamic training on learning curves and skill transfer in a force-based laparoscopic task.","authors":"Jan-Willem Klok, Masie Rahimi, Roelf Postema, Sem Hardon, Hendrik Jaap Bonjer, Freek Daams, Jenny Dankelman, Tim Horeman","doi":"10.1080/13645706.2026.2732156","DOIUrl":"https://doi.org/10.1080/13645706.2026.2732156","url":null,"abstract":"<p><strong>Background: </strong>Laparoscopic training is essential for developing safe and effective surgical skills. While most training tasks are performed in static environments, intra-abdominal conditions are inherently dynamic due to physiological motion. Although dynamic training may therefore enhance skill acquisition and transfer, its effects on force-based laparoscopic tasks remain unclear.</p><p><strong>Methods: </strong>In this randomized controlled study, 18 novices performed a force-based wire chaser task in a laparoscopic box trainer. Participants were assigned to a Static or Dynamic training group. The Dynamic group trained on a moving platform, while the Static group trained without movement. All participants completed four training trials, followed by a dynamic test and a static test. Four key objective performance metrics (time, mean non-zero force, maximum force, and path length) were recorded. Primary analyses compared between-group differences. Secondary analyses assessed within-group learning (trial 1 vs 4) and transition effects (trial 4 vs dynamic and static tests).</p><p><strong>Results: </strong>No significant differences between groups were observed at the predefined primary assessment points and both groups demonstrated significant learning effects during training. Transition analyses showed that participants trained statically exhibited increased force application and movement when performing the dynamic test, whereas no significant transition effects were observed in the Dynamic group. Conversely, limited improvements were observed when transitioning to the static task. Data distribution suggested that a subset of participants in the Dynamic group achieved relatively high performance during the dynamic test.</p><p><strong>Conclusions: </strong>In this study, dynamic training did not result in superior overall performance compared to static training in this force-based task. However, it may influence learning strategies and adaptability, particularly for a subset of learners. Dynamic training may therefore serve as a complementary modality to increase task complexity and adaptability. Future research should investigate long-term effects on skill acquisition and explore the urgency for dynamic tasks in laparoscopic training curricula.</p>","PeriodicalId":18537,"journal":{"name":"Minimally Invasive Therapy & Allied Technologies","volume":" ","pages":"1-10"},"PeriodicalIF":1.8,"publicationDate":"2026-10-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149183136","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Short- and mid-term outcomes of SASI vs OAGB: a propensity score-matched study.","authors":"Marco Maria Lirici, Beniamino Pascotto, Juan Santiago Azagra, Cristian Vito Benegiamo, Biagio Capasso, Alessandra Sguera, Vittorio Corso, Marco Visconti, Marco Antonio Zappa","doi":"10.1080/13645706.2026.2743534","DOIUrl":"https://doi.org/10.1080/13645706.2026.2743534","url":null,"abstract":"<p><strong>Background: </strong>This interim analysis evaluated the safety and efficacy of single anastomosis sleeve-ileal bypass (SASI) versus one-anastomosis gastric bypass (OAGB), and determined the optimal sample size for a prospective observational study using propensity score-matched (PSM) analysis. The short- and mid-term findings are reported herein.</p><p><strong>Methods: </strong>By the mid-term analysis, 208 patients had completed at least six months of follow-up (108 SASI; 100 OAGB). Patients were matched 1:1 using propensity scores based on demographics, anthropometric measures and major comorbidities. Procedures were performed laparoscopically or robotically by experienced bariatric surgeons. Inverse probability of treatment weighting (IPTW) using average treatment effect among the treated weights was conducted as a sensitivity analysis.</p><p><strong>Results: </strong>The planned sample size of 394 patients per group was not reached. After matching, no statistically significant differences in postoperative outcomes were detected between groups at 6, 12, or 18 months. Excess weight loss increased from 64.91% to 101.74% after OAGB and from 61.70% to 92.62% after SASI between short- and mid-term follow-up. At 18 months, all patients in both groups achieved medication-free blood glucose control.</p><p><strong>Conclusions: </strong>SASI appeared feasible, with no significant differences from OAGB in reported short- and mid-term outcomes. The study remains underpowered; longer follow-up and the planned sample size are needed.</p>","PeriodicalId":18537,"journal":{"name":"Minimally Invasive Therapy & Allied Technologies","volume":" ","pages":"1-13"},"PeriodicalIF":1.8,"publicationDate":"2026-10-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149110803","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Robot-assisted partial nephrectomy in the era of novel robotic platforms: the first european experience with the toumai^® system.","authors":"Attilio Barretta, Paweł Wisz, Alessio Guidotti, Francesco Cei, Edoardo Beatrici, Natali Rodriguez Peñaranda, Francesco Prata, Francesco Pepillo, Mario de Angelis, Nicolas Carl, Claudio Brancelli, Vincenzo Cavarra, Valerio Santarelli, Federico Lavagno, Angelo Mottaran, Pietro Piazza, Lorenzo Bianchi, Robin Hamal, Edward Lambert, Pieter De Backer, Ruben De Groote, Geert De Naeyer, Riccardo Schiavina, Alexandre Mottrie","doi":"10.1080/13645706.2026.2711930","DOIUrl":"10.1080/13645706.2026.2711930","url":null,"abstract":"<p><strong>Background: </strong>To evaluate the feasibility and safety of robot-assisted partial nephrectomy (RAPN) performed using the Toumai^® robotic system in this first European experience.</p><p><strong>Methods: </strong>We conducted a prospective observational study including consecutive patients undergoing RAPN performed using the Toumai^® robotic system at a tertiary referral robotic centre between May and December 2025. Perioperative, postoperative, functional, and pathological data were collected.</p><p><strong>Results: </strong>A total of 21 RAPN procedures were performed using the Toumai^® robotic system. Median patient age was 63 years, and 15 patients (71.4%) were male. Median tumour diameter was 3.2 cm. Median total operative time was 143 min, with a median console time of 90 min. No conversions to open surgery or radical nephrectomy occurred. Two robot-related technical events (9.5%) were recorded and managed intraoperatively without clinical consequences. One postoperative complication occurred (4.8%), graded as Clavien-Dindo I. No major complications, blood transfusions, or early readmissions (<30 days) were observed. Median length of hospital stay was three days. Median estimated glomerular filtration rate (eGFR) showed a minimal change at hospital discharge, with a median ΔeGFR of -2 mL/min/1.73m² (<i>p</i> = 0.2).</p><p><strong>Conclusion: </strong>In this first European experience, RAPN performed using the Toumai^® robotic system was feasible and safe. Further studies are required to confirm long-term outcomes and comparative performance.</p>","PeriodicalId":18537,"journal":{"name":"Minimally Invasive Therapy & Allied Technologies","volume":" ","pages":"375-382"},"PeriodicalIF":1.8,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148794955","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Design of a steam thermal ablation system for liver tumors and its efficacy evaluation based on fluorescence imaging.","authors":"Jingqi Song, Wei Wei, Haotian Wang, Kairan Wan, Zhiyu Qian, Lidong Xing, Xiaofei Jin","doi":"10.1080/13645706.2026.2666590","DOIUrl":"10.1080/13645706.2026.2666590","url":null,"abstract":"<p><strong>Background: </strong>At present, traditional minimally invasive thermal ablation technologies are all derived from electromagnetic radiation energy generated by high-frequency, high-energy physical sources. Consequently, they all share common issues, such as poor conformability, carbonization, difficulty controlling temperature, and electromagnetic radiation.</p><p><strong>Methods: </strong>This paper proposes a steam thermal ablation (STA) technology that utilizes the internal energy of saturated steam to replace traditional electromagnetic radiation-based energy sources. Using a self-built, minimally invasive steam thermal ablation precision treatment system for liver tumors and a steam ablation needle designed via COMSOL simulation, ex vivo pig liver experiments were conducted. Based on STA characteristics, a real-time monitoring scheme for the ablation boundary has been proposed using fluorescence imaging.</p><p><strong>Results: </strong>The results of STA are characterized by a maximal ablation axis ratio (short diameter/long diameter) and the absence of carbonization. The fluorescence-based monitoring effectively eliminated artifacts and radiation constraints typical of ultrasound or CT-guided procedures.</p><p><strong>Conclusions: </strong>Steam thermal ablation (STA) technology offers a novel thermal ablation method, featuring good conformability and no carbonization. Combined with real-time fluorescence imaging monitoring, it provides a feasible solution for the limitations of traditional minimally invasive thermal ablation techniques.</p>","PeriodicalId":18537,"journal":{"name":"Minimally Invasive Therapy & Allied Technologies","volume":" ","pages":"392-403"},"PeriodicalIF":1.8,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147942002","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Ejaculation-sparing GreenLight anatomical PVP versus REZŪM for benign prostatic obstruction surgery with an ejaculation-sparing purpose: what are the early differences?","authors":"Paolo Destefanis, Mattia Sibona, Marco Oderda, Eugenia Vercelli, Gabriele Montefusco, Fulvia Colucci, Matteo Ghio, Paolo Gontero","doi":"10.1080/13645706.2026.2656310","DOIUrl":"10.1080/13645706.2026.2656310","url":null,"abstract":"<p><strong>Background: </strong>Surgery for benign prostatic obstruction (BPO) is often associated with postoperative ejaculatory dysfunction. Traditional techniques like transurethral resection of the prostate (TUR-P) or open prostatectomy (OP) effectively relieve lower urinary tract symptoms (LUTS) but usually compromise antegrade ejaculation. Minimally invasive surgical techniques (MISTs), such as Rezūm^® or modified endoscopic surgeries, like the ejaculation-sparing anatomical photoselective vaporization of the prostate (ESa-PVP), were developed to preserve sexual function while ensuring symptom relief. However, few comparative data are available. Our study aims to compare the early functional and sexual outcomes of Rezūm^® and ESa-PVP in BPO.</p><p><strong>Methods: </strong>This prospective, non-randomised study analysed two cohorts of men with LUTS unresponsive to medication or an indwelling catheter, surgically treated at our centre between December 2022 and December 2023. The primary outcome of the study was the assessment of postoperative antegrade ejaculation. Secondary outcomes included LUTS evaluation and surgical complications. Postoperative outcomes were assessed after three months by administering validated questionnaires: International Prostate Symptom Score (IPSS), International Index of Erectile Function-5 (IIEF-5), and Male Sexual Health Questionnaire-Ejaculatory Dysfunction, short form (MSHQ-EjD).</p><p><strong>Results: </strong>A total of 54 patients were evaluated (31 Rezūm, 23 ESa-PVP). After three months, the ESa-PVP showed a better improvement of both IPSS scores (<i>p</i> = 0.009) and patient-perceived quality of life (<i>p</i> = 0.008). No significant differences were found in erectile function (IIEF-5 scores, <i>p</i> = 0.340), while the MSHQ-EjD scores were significantly higher in the Rezūm group (<i>p</i> = 0.001). Ejaculation was maintained in 26 out of 31 (83%) Rezūm patients versus 14 out of 23 (60%) ESa-PVP patients (<i>p</i> = 0.056).</p><p><strong>Conclusions: </strong>Rezūm^® and ESa-PVP are both effective and safe procedures for the treatment of BPO. While the ESa-PVP seems to provide better symptom relief in the short term, Rezūm^® showed higher rates of immediate antegrade ejaculation preservation. Personalised counselling is crucial to achieve optimal patient satisfaction.</p>","PeriodicalId":18537,"journal":{"name":"Minimally Invasive Therapy & Allied Technologies","volume":" ","pages":"383-391"},"PeriodicalIF":1.8,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147776128","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Acceptance and perceived usefulness of surgical video instructions in expert-tutored open and robotic pancreato- and hepaticojejunostomy training with 3D biotissue models.","authors":"Laetitia Zoe Hampe, Amila Cizmic, Frida Häberle, Rebecca Angresius, Kira Meißner, Hannah Wille, Piera Domroese, Matteo Mueller, Jan Philipp Jonas, Maxime De Wulf, Stefan Bouwense, Otmar Buyne, Ville Sallinen, Stefan Breitenstein, Philip C Müller, Marko Kraljevic, Lana Fourie, Stefan Holland-Cunz, Floris Ferenschild, Caroline Williamsson, Christoph Reissfelder, Christiane Bruns, Christian Toso, Benjamin Weixler, Beat Peter Müller, Pierre Alain Clavien, Friedrich Herbst, Peter Vogelbach, Dieter Hahnloser, Stephan Bischofberger, Walter Brunner, Alain Sauvanet, Sébastien Gaujoux, Sven Mieog, Stefano Partelli, Elena Rangelova, Jérôme Ammann, Eva Boldrini, Lars Vanderbroeck, Rainer Grotelüschen, Philipp Busch, Faik Güntac Uzunoglu, Anna Nießen, Tarik Ghadban, Asmus Heumann, Nathaniel Melling, Ramez Wahib, Oliver Mann, Anna Dupree, Thilo Hackert, Harry van Goor, Felix Nickel, Anas Amin Preukschas","doi":"10.1080/13645706.2026.2693302","DOIUrl":"10.1080/13645706.2026.2693302","url":null,"abstract":"<p><strong>Background: </strong>Suturing complex anastomoses requires repetitive training for mastery. Expert tutoring is a limited and costly ressource. This study assessed the added value of surgical video instructions in expert-tutored hepatopancreatobiliary (HPB) surgery courses.</p><p><strong>Methods: </strong>Trainees and tutors used QR codes to access instructional videos of pancreatico- and hepaticojejunostomy (04/2024-09/2025: Davos course for HPB Surgery; Hands-On- Course of the North-German Surgical Association; ESSO Course Pancreatic Surgery). After watching videos and performing anastomoses on 3D-biotissue organ models, participants anonymously completed standardized questionnaires.</p><p><strong>Results: </strong>Out of 51 participants (20 residents; 31 specialists), most reported that QR codes facilitated video access (n=48, 96%). The majority found the videos useful (n=31, 62%). Most preferred a combination of expert tutoring and surgical video instructions (n=49, 96%) and agreed that expert tutoring was more effective when supported by videos (n=44, 86%). Furthermore, 28 (55%) participants felt they could improve their surgical skills with the videos in self-directed training without expert guidance. Older and more experienced participants were more likely to agree that videos added value to expert tutoring.</p><p><strong>Conclusion: </strong>Surgical video instructions were well accepted and perceived as valuable additions to expert-tutored courses on HPB anastomoses. Further studies should assess translation into improved training outcomes.</p>","PeriodicalId":18537,"journal":{"name":"Minimally Invasive Therapy & Allied Technologies","volume":" ","pages":"366-374"},"PeriodicalIF":1.8,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148471623","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Laparoscopic coeliac axis decompression for Dunbar syndrome: a step-by-step technical note.","authors":"Alessia Dessì, Mauro Podda, Raimondo Sanna, Francesco Casti, Francesca Morinello, Lisa Seu, Eleonora Silanos, Adolfo Pisanu","doi":"10.1080/13645706.2026.2706593","DOIUrl":"10.1080/13645706.2026.2706593","url":null,"abstract":"<p><strong>Background: </strong>Median arcuate ligament syndrome is a rare cause of chronic postprandial abdominal pain due to extrinsic compression of the coeliac trunk. Surgical decompression remains the mainstay of treatment.</p><p><strong>Methods: </strong>We report a step-by-step technical note of laparoscopic coeliac axis decompression in a 31-year-old woman with long-standing postprandial abdominal pain, nausea, and vomiting. Preoperative CT angiography demonstrated focal stenosis of the coeliac trunk, confirmed by colour duplex ultrasonography. This technical note provides a reproducible description of the laparoscopic approach, focusing on anatomical exposure, vascular landmarks, safe dissection along the anterior aortic plane, and complete coeliac axis release.</p><p><strong>Results: </strong>Operative time was 90 min. The postoperative course was uneventful. The patient reported complete symptom resolution and tolerated a solid diet from the second postoperative day. She was discharged home on postoperative day four. Two-week CT angiography showed restoration of coeliac trunk calibre, with no residual stenosis or extrinsic compression. Duplex ultrasonography at two months demonstrated no abnormalities in peak systolic velocity.</p><p><strong>Conclusions: </strong>Laparoscopic coeliac axis decompression is a safe and feasible option in patients with Dunbar syndrome. Magnified exposure may facilitate safe dissection and complete release. Clinical follow-up should combine objective vascular imaging with assessment of functional outcomes and quality of life.</p>","PeriodicalId":18537,"journal":{"name":"Minimally Invasive Therapy & Allied Technologies","volume":" ","pages":"404-408"},"PeriodicalIF":1.8,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148549598","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Immersive endoscopy: potential usefulness from an ergonomic perspective.","authors":"Shinnosuke Nagano, Kota Momose, Takamitsu Kato, Yuji Ishii, Shuhei Yamaguchi, Takaomi Hagi, Kotaro Yamashita, Takuro Saito, Koji Tanaka, Tomoki Makino, Tsuyoshi Takahashi, Yukinori Kurokawa, Hidetoshi Eguchi, Yuichiro Doki, Kiyokazu Nakajima","doi":"10.1080/13645706.2026.2693303","DOIUrl":"10.1080/13645706.2026.2693303","url":null,"abstract":"<p><strong>Background: </strong>In flexible endoscopy, ergonomic issues such as suboptimal monitor positioning are becoming increasingly important. Head-mounted display (HMD) technology may provide an ergonomic environment independent of room setup or endoscopist posture. This study evaluated the feasibility and ergonomic benefits of immersive endoscopy using HMD technology.</p><p><strong>Methods: </strong>We used the Apple Vision Pro (AVP), a video see-through HMD. Participants performed an endoscopic marking task under three monitor settings: ergonomic, non-ergonomic, and immersive. Procedure time, muscle effort by wireless electromyography, and mental workload by NASA-TLX were compared.</p><p><strong>Results: </strong>Eleven endoscopists participated. Compared with the non-ergonomic setting, the immersive and ergonomic settings showed significantly shorter procedure times and lower mental workload, with no difference between the immersive and ergonomic settings. Both immersive and ergonomic settings also showed significantly lower muscle activation in the trapezius, posterior neck, and left sternocleidomastoid muscles than the non-ergonomic setting. In addition, compared with the ergonomic setting, immersive endoscopy showed significantly lower activation in the trapezius, erector spinae, and right sternocleidomastoid muscles.</p><p><strong>Conclusions: </strong>Immersive endoscopy using AVP improved performance and reduced muscle effort and mental workload compared with the non-ergonomic setting, while reducing activation in specific postural muscles even compared with the ergonomic setting.</p>","PeriodicalId":18537,"journal":{"name":"Minimally Invasive Therapy & Allied Technologies","volume":" ","pages":"356-365"},"PeriodicalIF":1.8,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148376053","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Artificial intelligence in surgery: safety before automation.","authors":"Alberto Arezzo","doi":"10.1080/13645706.2026.2711323","DOIUrl":"10.1080/13645706.2026.2711323","url":null,"abstract":"","PeriodicalId":18537,"journal":{"name":"Minimally Invasive Therapy & Allied Technologies","volume":" ","pages":"341-344"},"PeriodicalIF":1.8,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148701662","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Organ-sparing transanal endoscopic microsurgery for malignant rectal tumours: long-term survival and predictors of recurrence in a 333-patient cohort.","authors":"Alberto Arezzo, Carlo Alberto Ammirati, Giovanni Distefano, Michele Barbiero, Roberto Passera, Mario Morino","doi":"10.1080/13645706.2026.2703162","DOIUrl":"10.1080/13645706.2026.2703162","url":null,"abstract":"<p><strong>Background: </strong>Long-term outcomes and preoperative predictors after organ-sparing transanal endoscopic microsurgery (TEM) for rectal cancer remain incompletely defined. We assessed overall survival (OS), disease-free survival (DFS), and preoperative predictors.</p><p><strong>Methods: </strong>Consecutive patients undergoing TEM with organ-sparing intent for rectal adenocarcinoma between February 1993 and April 2025 were retrospectively analysed. Preoperative variables included age, sex, lesion diameter, distance from the anal verge, location, histology, and endoscopic ultrasound (EUS) uT stage. Survival was estimated by Kaplan-Meier analysis and Cox regression.</p><p><strong>Results: </strong>333 patients were included (median age 71 years; 63.1% male), with a median follow-up of 24 months. Post-TEM management comprised surveillance (28.5%), completion radical surgery (17.1%), or (chemo)radiotherapy (44.7%). Rectal preservation was achieved in 73.3%. 88 patients died and 71 developed recurrence, including 58 local and 26 distant recurrences. On multivariable analysis, age ≥71 years (adjusted HR 2.35, 95% CI 1.38-4.00; <i>p</i> = 0.002) and EUS uT2-3 (adjusted HR 2.11, 95% CI 1.23-3.63; <i>p</i> = 0.007) independently predicted worse OS.</p><p><strong>Conclusions: </strong>Organ-sparing TEM achieved rectal preservation in nearly three-quarters of patients, although recurrence was predominantly local. Age and EUS uT stage predicted OS, supporting staging and risk-adapted escalation.</p>","PeriodicalId":18537,"journal":{"name":"Minimally Invasive Therapy & Allied Technologies","volume":" ","pages":"345-355"},"PeriodicalIF":1.8,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148830130","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}