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Transanal Endoscopic Microsurgery (TEM) for rectal GI stromal tumor
S Punnen1, A A Karimuddin2, M J Raval2
1University of British Columbia, 2329 West Mall, Vancouver, BC, v6t1z4, Canada.
American Journal of Surgery
|August 13, 2020
Summary
Transanal endoscopic microsurgery (TEM) is a safe treatment for rectal gastrointestinal stromal tumors (GISTs). While rare, TEM can achieve negative margins and effectively manage local recurrence in rectal GIST patients.
Area of Science:
- Gastroenterology
- Surgical Oncology
- Rectal Surgery
Background:
- Transanal endoscopic microsurgery (TEM) is established for rectal adenomas and early cancers.
- Rectal gastrointestinal stromal tumors (GISTs) are rare malignancies.
- The efficacy of TEM for rectal GISTs requires evaluation.
Purpose of the Study:
- To assess the safety and effectiveness of TEM for treating early rectal GISTs.
- To analyze outcomes of TEM in patients with rectal GISTs.
Main Methods:
- A prospective database identified 7 patients with rectal GIST treated with TEM over 10 years.
- Demographic, pathologic, operative, and follow-up data were collected and analyzed.
- Descriptive statistics were used to present the findings.
Main Results:
- Seven rectal GIST cases were treated with TEM, with a median follow-up of 31 months.
- Median tumor distance was 4 cm from the anal verge, and median size was 3 cm.
- Negative margins were achieved in 4/7 patients; one local recurrence was successfully retreated with TEM.
Conclusions:
- TEM is a safe procedure for the local excision of rectal GISTs.
- Due to the rarity of rectal GISTs, a multicenter registry is recommended to further clarify treatment outcomes.
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