• Skip to primary navigation
  • Skip to main content
  • Skip to primary sidebar
  • Skip to footer

SAGES

Reimagining surgical care for a healthier world

  • Home
    • COVID-19 Annoucements
    • Search
    • SAGES Home
    • SAGES Foundation Home
  • About
    • Who is SAGES?
    • SAGES Mission Statement
    • Advocacy
    • Strategic Plan, 2020-2023
    • Committees
      • Request to Join a SAGES Committee
      • SAGES Board of Governors
      • Officers and Representatives of the Society
      • Committee Chairs and Co-Chairs
      • Full Committee Rosters
      • SAGES Past Presidents
    • Donate to the SAGES Foundation
    • Awards
      • George Berci Award
      • Pioneer in Surgical Endoscopy
      • Excellence In Clinical Care
      • International Ambassador
      • IRCAD Visiting Fellowship
      • Social Justice and Health Equity
      • Excellence in Community Surgery
      • Distinguished Service
      • Early Career Researcher
      • Researcher in Training
      • Jeff Ponsky Master Educator
      • Excellence in Medical Leadership
      • Barbara Berci Memorial Award
      • Brandeis Scholarship
      • Advocacy Summit
      • RAFT Annual Meeting Abstract Contest and Awards
  • Meetings
    • NBT Innovation Weekend
    • SAGES Annual Meeting
      • 2023 Scientific Session Call For Abstracts
      • 2023 Emerging Technology Call For Abstracts
    • CME Claim Form
    • Industry
      • Advertising Opportunities
      • Exhibit Opportunities
      • Sponsorship Opportunities
    • Future Meetings
    • Past Meetings
      • SAGES 2022
      • SAGES 2021
    • Related Meetings Calendar
  • Join SAGES!
    • Membership Benefits
    • Membership Applications
      • Active Membership
      • Affiliate Membership
      • Associate Active Membership
      • Candidate Membership
      • International Membership
      • Medical Student Membership
    • Member News
      • Member Spotlight
      • Give the Gift of SAGES Membership
  • Patients
    • Healthy Sooner – Patient Information for Minimally Invasive Surgery
    • Patient Information Brochures
    • Choosing Wisely – An Initiative of the ABIM Foundation
    • All in the Recovery: Colorectal Cancer Alliance
    • Find a SAGES Member
  • Publications
    • SAGES Stories Podcast
    • SAGES Clinical / Practice / Training Guidelines, Statements, and Standards of Practice
    • Patient Information Brochures
    • TAVAC – Technology and Value Assessments
    • Surgical Endoscopy and Other Journal Information
    • SAGES Manuals
    • SCOPE – The SAGES Newsletter
    • COVID-19 Annoucements
    • Troubleshooting Guides
  • Education
    • OpiVoid.org
    • SAGES.TV Video Library
    • Safe Cholecystectomy Program
      • Safe Cholecystectomy Didactic Modules
    • Masters Program
      • SAGES Facebook Program Collaboratives
      • Acute Care Surgery
      • Bariatric
      • Biliary
      • Colorectal
      • Flexible Endoscopy (upper or lower)
      • Foregut
      • Hernia
      • Robotics
    • Educational Opportunities
    • HPB/Solid Organ Program
    • Courses for Residents
      • Advanced Courses
      • Basic Courses
    • Video Based Assessments (VBA)
    • Robotics Fellows Course
    • MIS Fellows Course
    • Facebook Livestreams
    • Free Webinars For Residents
    • SMART Enhanced Recovery Program
    • SAGES OR SAFETY Video
    • SAGES at Cine-Med
      • SAGES Top 21 MIS Procedures
      • SAGES Pearls
      • SAGES Flexible Endoscopy 101
      • SAGES Tips & Tricks of the Top 21
  • Opportunities
    • NEW-Area of Concentrated Training Seal (ACT)-Advanced Flexible Endoscopy-Coming Soon!
    • SAGES Fellowship Certification for Advanced GI MIS and Comprehensive Flexible Endoscopy
    • Multi-Society Foregut Fellowship Certification
    • SAGES Research Opportunities
    • Fundamentals of Laparoscopic Surgery
    • Fundamentals of Endoscopic Surgery
    • Fundamental Use of Surgical Energy
    • Job Board
    • SAGES Go Global: Global Affairs and Humanitarian Efforts
  • Search
    • Search All SAGES Content
    • Search SAGES Guidelines
    • Search the Video Library
    • Search the Image Library
    • Search the Abstracts Archive
  • Store
    • “Unofficial” Logo Products
  • Log In

MASS SPECTROMETRY TRANSANAL MINIMALLY INVASIVE SURGERY (MS-TAMIS) FOR ORGAN PRESERVATION IN RECTAL CANCER

Sam Mason, MBBS, BSc, MRCS, Liam Poynter, MBBS, BSc, MRCS, Efty Manoli, MSc, James Alexander, MBBS, MRCP, Petra Paizs, Bsc, Afeez Adebesin, RN, Robert Goldin, PhD, FRCPath, Ara Darzi, MD, FRCS, FACS, FRS, Zoltan Takats, PhD, James Kinross, PhD, FRCS. Imperial College London

Objectives: The unmet need in organ preservation strategies for rectal cancer is accurate, preoperative stratification of lesion risk, in addition to effectively deployed surgical options such as TAMIS. Rapid Evaporative Ionisation Mass Spectrometry (REIMS) provides a platform for real time biochemical tissue analysis which, when coupled to existing endoscopic and surgical devices, provides unique biological insight. Here, we assessed the accuracy of REIMS in the diagnosis, risk stratification and therapeutic intervention in rectal cancer.

Methods: In this prospective pilot study, we recruited patients who underwent diagnostic colonoscopy or surgical resection for either rectal adenoma or cancer at two London hospitals. A modified, monopolar, electrosurgical handpiece was used to analyze tissues ex vivo, with the smoke plume aspirated directly into a Xevo G2-S ToF mass spectrometer (Waters Corporation). The relative abundance of cellular lipids was subjected to multivariate statistical modelling, including orthogonal partial–least-squares discriminant analysis. The primary outcome was the ability of REIMS to differentiate normal, adenomatous and cancerous rectal tissue. Secondary outcomes were the ability of REIMS to predict the presence of nodal disease, advanced tumor stage and histological features of poor prognosis.

Results: 37 patients with mean age of 70 were included in the study, yielding 225 spectra (108 normal, 82 tumour, 35 adenoma). Of the 26 patients who underwent surgical resection, 16 had nodal disease and 16 had T3/4 stage (as per TNM v7). REIMS differentiates normal, adenomatous and cancerous rectal tissues in real time with a diagnostic accuracy of 99.1%. For rectal cancers, REIMS had a sensitivity and specificity of 100% and 99.1% respectively for the presence of nodal disease, compared to 50% and 75% for pre-operative radiology. Furthermore, REIMS had a sensitivity of 93.3% and specificity of 98.8% in predicting tumors with advanced stage, compared to 69.2% and 42.9% respectively for preoperative radiology. Prognostic histological features could be predicted including extramural venous invasion (area under the curve (AUC) 1), tumor budding (AUC 0.99) and lymphovascular invasion (AUC 0.99). This technology has been translated into clinical practice where we have performed the first four in man studies of mass spectrometry augmented TAMIS, giving the surgeon real time biological feedback.

Conclusions: By sampling cellular lipids in real time, REIMS can accurately risk stratify rectal cancers based on underlying biology, potentially guiding clinical decision-making to promote organ preservation. There is also a role for improving the efficacy of rectal-sparing surgery, demonstrated in this initial cohort of augmented MS-TAMIS.


Presented at the SAGES 2017 Annual Meeting in Houston, TX.

Abstract ID: 95243

Program Number: S129

Presentation Session: Colorectal III

Presentation Type: Podium

52

Share this:

  • Twitter
  • Facebook
  • LinkedIn
  • Pinterest
  • WhatsApp
  • Reddit

Related

« Return to SAGES 2019 abstract archive

Our Mission

Innovate, educate and collaborate to improve patient care.

Recently, on SAGES…

Critical View of Safety (CVS) Challenge QR Code

The SAGES Critical View of Safety Challenge – Donate Your Lap Chole Videos!

The Society of American Gastrointestinal and Endoscopic Surgeons is hosting the first Artificial Intelligence Data Challenge conducted by surgeons. The aim of this challenge is to generate a large and diverse dataset of laparoscopic cholecystectomy videos, annotated with respect to the subcomponents of the Critical View of Safety (CVS). Computer scientists from all over the […]

Respuesta de SAGES al Estudio NordICC sobre el beneficio de las colonoscopias de detección

SAGES desea aclarar los resultados del estudio NordICC y colocarlos en contexto de los esfuerzos de varias agencias nacionales para reducir el riesgo de cáncer colorrectal – la segunda causa de muerte por cáncer más frecuente en los Estados Unidos-, mediante la promoción de la detección y tratamiento oportuno de las lesiones.

SAGES Response to NordICC Study Regarding Benefit of Screening Colonoscopies

The NordICC Study recently published in The New England Journal of Medicine and widely reported on by media outlets has raised questions regarding the benefit of screening colonoscopy in lowering the risk of colorectal cancer and cancer-related deaths among otherwise healthy and symptom-free men and women aged 55 to 64. Provocative headlines and commentaries have […]

Contact SAGES

Society of American Gastrointestinal and Endoscopic Surgeons
11300 W. Olympic Blvd Suite 600
Los Angeles, CA 90064 USA
webmaster@sages.org
Tel: (310) 437-0544

Find Us Around the Web!

  • Facebook
  • Twitter
  • YouTube

Important Links

SAGES 2023 Meeting Information

Healthy Sooner: Patient Information

SAGES Guidelines, Statements, & Standards of Practice

SAGES Manuals

 

  • taTME Study Info
  • Foundation
  • SAGES.TV
  • MyCME
  • Educational Activities

Copyright © 2023 Society of American Gastrointestinal and Endoscopic Surgeons