Mass spectrometry transanal minimally invasive surgery (MS-TAMIS) to promote organ preservation in rectal cancer

• DOI: 10.1007/s00464-019-07140-y
• Publication Date: 2019-10-15T21:16:39Z
• Authors: Sam Mason; Eftychios Manoli; Liam Poynter; James Alexander; Petra Paizs; Afeez Adebesin; Robert Goldin; Ara Darzi; Zoltan Takats; James Kinross
• Keywords: Invasive surgery

Transanal minimally invasive surgery (TAMIS) is deployed for organ preservation in early rectal cancer and significant polyps. Rapid evaporative ionisation mass spectrometry (REIMS) provides biochemical tissue analysis, which could be applied intraoperatively to give real-time feedback the surgeon decrease risk of an involved margin. However, accuracy feasibility this approach have not been established.In prospective observational study, patients undergoing resection adenomas or carcinomas were recruited. An electrosurgical handpiece analysed tissues ex vivo using diathermy, with aerosol aspirated into a Xevo G2-S ToF spectrometer. The relative abundance lipids underwent predictive statistical modelling leave-one-patient-out cross-validation. outcomes interest ability REIMS differentiate normal, adenomatous cancerous tissue, any disease subtype from normal. was coupled TAMIS sampling, assessing recognition distinguishing bowel wall layers.Forty-seven included, yielding 266 spectra (121 109 tumour 36 adenoma). differentiates 86.8% accuracy, normal 92.4% 91.4% when differentiating We performed first five in-man augmented (MS-TAMIS). In real time, MS-TAMIS can mucosa submucosa based on their triglycerides glycerophospholipids. diseased maintained at 90%, negative value 95%. system identified deep lateral margin during TAMIS.REIMS distinguishes types underlying lipid biology, translated by coupling it TAMIS. There role technology improving efficacy cancers.