Transanal Excision (TAE)

minimum cost

₱ 0

maximum cost

₱ 0

Things you need to know

What is Transanal Excision ?

Why do you need Transanal Excision ?

Transanal excision is indicated for:

Benign rectal polyps: Large or villous adenomas not removable via colonoscopy.
Early-stage rectal cancer: T1N0M0 tumors (small, superficial, no lymph node involvement), with low risk of metastasis.
Palliative cases: For patients unfit for major surgery (e.g., elderly, comorbidities) to relieve symptoms like bleeding or obstruction.
Select neuroendocrine tumors: Small, well-differentiated rectal carcinoids.

The procedure aims to remove the lesion with clear margins while preserving rectal function and avoiding a permanent stoma.

Why Do Costs Vary in Philippines?

Transanal Excision Procedure

The procedure is tailored to the lesion’s size, location, and pathology:

Before Surgery Evaluation:
- Diagnosis:
  - Rectal exam and proctoscopy visualize the lesion.
  - Endorectal ultrasound (ERUS) or MRI assesses tumor depth (T stage) and lymph node involvement.
  - Biopsy confirms pathology (adenoma, T1 cancer, or carcinoid).
  - CT/PET scans rule out metastasis for cancer cases.
- Blood tests ensure surgical fitness; patients on blood thinners may need to stop them 5–7 days prior.
- Bowel preparation (enema) clears the rectum on the day of surgery.
- Patients are counseled on risks, including recurrence and the potential need for further surgery.
Surgical Techniques:
- Standard Transanal Excision (TAE):
  - Performed under general or spinal anesthesia, lasting 30–60 minutes.
  - The patient is positioned in the lithotomy position (legs raised).
  - An anoscope or retractor exposes the lesion in the rectum.
  - The tumor is excised with a 1 cm margin of healthy tissue using surgical instruments, ensuring full-thickness removal down to the perirectal fat for cancers.
  - The defect in the rectal wall is closed with sutures, though small defects may be left open to heal naturally.
- Transanal Endoscopic Microsurgery (TEM):
  - A specialized technique using a rigid proctoscope with a stereoscopic camera and instruments.
  - Provides better visualization and precision for lesions 6–10 cm from the anal verge.
  - Takes 1–2 hours; suitable for larger or more proximal lesions.
- Transanal Minimally Invasive Surgery (TAMIS):
  - A newer approach using a flexible transanal platform (e.g., GelPOINT Path) and laparoscopic instruments.
  - Offers similar precision to TEM but with more flexibility and lower equipment costs.
  - Takes 1–2 hours; increasingly available in centers like Apollo or Medanta.
- The procedure is outpatient or requires a 1–2 day hospital stay.
After Surgery:
- Patients are monitored for a few hours for pain control and to ensure no immediate complications.
- Pathology reports confirm clear margins and tumor stage, guiding further management (e.g., surveillance or additional surgery for cancer).
- Follow-up visits assess healing and recurrence.

Recovery After Transanal Excision

Hospital Stay: Outpatient or 1–2 days.
Post-Surgery Care:
- Mild pain for 3–5 days, managed with painkillers (e.g., paracetamol) and sitz baths.
- Antibiotics are prescribed if infection risk is high.
- Stool softeners (e.g., lactulose) prevent straining.
Activity/Diet:
- Light activities resume in 1–2 days; strenuous activities avoided for 2–3 weeks.
- High-fiber diet (fruits, vegetables, whole grains) and 2–3 liters water daily promote soft stools.
- Avoid spicy foods for 3–5 days to reduce irritation.
Follow-Up:
- Visits at 1–2 weeks, 4–6 weeks; cancer patients need proctoscopy/ERUS every 3–6 months for 2–3 years, then annually.
- Healing completes in 2–4 weeks.

Most resume normal activities in 1–2 weeks. Success rates are 90–95% for benign lesions; local recurrence for T1 cancers is 5–15%, often requiring further surgery.

Risks and Complications

Surgical Risks: Bleeding (1–3%), infection, rectal perforation (rare, may require repair).
Functional Issues: Temporary incontinence (2–5%, resolves in weeks), rectal stenosis (rare).
Cancer-Specific Risks: Local recurrence (5–15% for T1 cancers), missed lymph node involvement (up to 10%), necessitating radical surgery (e.g., low anterior resection).
General Risks: Anesthesia reactions.

Report fever, severe pain, or rectal bleeding promptly.

Frequently Asked Questions (FAQs)

What causes the need for transanal excision?

Large rectal polyps, early-stage rectal cancer (T1), or small carcinoids.

Is it a major surgery?

No, it’s minimally invasive, avoiding abdominal incisions.

Can it treat all rectal cancers?

Only early-stage (T1) with low-risk features; advanced cancers need more extensive surgery.

How soon can I resume activities?

Light activities in 1–2 days, normal routines in 1–2 weeks.

Is it covered by insurance in India?

Yes, for cancer or symptomatic polyps; confirm with your provider.

Signs of complications?

Fever, severe pain, rectal bleeding, or incontinence.

Can cancer recur after transanal excision?

Yes, 5–15% risk for T1 cancers; regular surveillance is critical.

Lifestyle changes post-surgery?

High-fiber diet, hydration, avoid straining, regular follow-ups for cancer.

Conclusion

Looking for Best Hospitals for Transanal Excision

Note: we are not promoting any hospitals

We do not promote any hospitals. All details are sourced from Google and hospital websites. Please verify independently. Start with your surgery—here’s the list of government, budget, and superspecialty hospitals accredited by the Department of Health (DOH), Philippine Health Insurance Corporation (PhilHealth), and Joint Commission International (JCI)

click on your city and schedule your surgery now done in good hands.

City	Minimum Price (₱)	Maximum Price (₱)
Angeles City
Antipolo
Bacolod
Bacoor
Baguio
Butuan
Cagayan de Oro
Caloocan
Cebu City
Dasmariñas
Davao City
General Santos
General Trias
Iligan
Iloilo City
Las Piñas
Makati
Malolos
Manila
Muntinlupa
Parañaque
Pasay
Pasig
Puerto Princesa
Quezon City
San Fernando
San Jose del Monte
Taguig
Valenzuela
Zamboanga City

Disclaimer

This information is sourced from open platforms and is for general awareness only. Costs may vary based on individual cases. Please consult a qualified doctor for medical advice and explore options within your budget before deciding on the procedure.