TAMIS for Recurrent Cancer of the High Rectum (25 cm from the Anal Verge) in a Patient with Serious Associated Disorders (Rescue Surgery)

(≤3 cm and not >1/3 of rectal circumference), early-stage malignancies confined to the submucosa (t1 sm1 on kikuchi classification), neoplasms after an incomplete response to neoadjuvant treatment or with t1 residue, and t2-t3 n0 cancers in patients who cannot undergo major surgical resections (rescue surgery). tamis is especially recommended for neoplasms located at a distance of 5-18 cm from the anal verge. case presentation: we performed tamis on a 72-year-old patient with multiple morbidities diagnosed with diffuse polyposis syndrome, with a history of multiple recurrences treated with surgical resections, and with a new recurrence on the ileorectal anastomosis at about 25 cm from the anal verge. a rectoscopy and a total body computerized tomography were performed (anastomotic level; size 2 cm; staging: ct1-2, n0, m0; histology: adenocarcinoma). the final decision after a multidisciplinary meeting was for tamis, due to high intra- and post-operative risks contraindicating major surgery. data regarding total operating time, blood loss, length of stay, surgical and general intra- and post-operative complications, resumption of nutrition, and medications were collected. the operation was successful, with a total operating time of 55 minutes and an estimated blood loss of 20 ml. the patient was rapidly mobilized and nutrition was promptly resumed. the hospital stay was 3 days. no complications were observed. conclusion: in this case, we showed the feasibility and safety of the tamis resection at a greater distance than that normally recommended.