Para-sacral approach for large gastrointestinal stromal tumor of the lower rectum

Rectal gastrointestinal stromal tumor (GIST) is comparatively rare and usually already large when detected. As resection is the main therapy for patients with primary resectable GIST, the surgical procedure must be tailored to the tumor status. For GISTs of the lower rectum, laparoscopic low anterior resection or abdominoperineal resection is one of the procedures of choice. However, rectal tumor, including rectal GIST, can also be surgically treated using a variety of posterior approaches. Of these, para-sacral approach is both simple and less invasive, even for large rectal GISTs, and provides a good view of the operative field. Here, we describe our procedure for the surgical treatment of large GISTs of the lower rectum.