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Hybrid resection of massive rectal gastrointestinal stromal tumor using laparoscopic and transanal approaches
Author(s) -
Nagakari Kodai,
Matoba Shuichirou,
Toda Shigeo,
Maeda Yusuke,
Ueno Masashi,
Kuroyanagi Hiroya
Publication year - 2021
Publication title -
asian journal of endoscopic surgery
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.372
H-Index - 18
eISSN - 1758-5910
pISSN - 1758-5902
DOI - 10.1111/ases.12824
Subject(s) - medicine , rectum , abdominoperineal resection , gist , surgery , stromal tumor , imatinib mesylate , radical surgery , stromal cell , colorectal cancer , imatinib , cancer , myeloid leukemia
Rectal gastrointestinal stromal tumors (GISTs) are rare, and radical surgery such as abdominoperineal resection is necessary for large rectal GISTs to obtain tumor‐free resection margins. Here, we describe a 77‐year‐old man with a locally advanced non‐metastatic GIST in the left anterolateral wall of the lower rectum. Tumor size was estimated to be 73 mm, and invasion of the left seminal vesicle and prostate was suspected. Chemotherapy with imatinib mesylate reduced the tumor size, creating a slight gap between the tumor and anterior organs. Therefore, we performed sphincter‐sparing partial rectal resection using a hybrid method of laparoscopic and transanal approaches. The postoperative course was uneventful, and the patient remains disease‐free on adjuvant chemotherapy 12 months after surgery. This case suggests that a hybrid method of laparoscopic and transanal surgery allows oncological and function‐preserving excision of large rectal GISTs.