Chang Sheng-Chi, Ke Tao-Wei, Chiang Hua-Che, Wu Christina, Chen William Tzu-Liang
Division of Colorectal Surgery, Department of Surgery, China Medical University Hospital, Taichung, Taiwan.
Surg Laparosc Endosc Percutan Tech. 2010 Aug;20(4):284-7. doi: 10.1097/SLE.0b013e3181ec6889.
Gastrointestinal stromal tumors (GISTs) are rarely found in the anorectum and account for less than 0.3% of all rectal malignancies. The major treatment of rectal GISTs is complete resection of the primary tumor with negative microscopic margin. Here, we present an alternative method-laparoscopic-assisted local excision of rectal GIST. The patient had a 5x4x3 cm GIST located 4 cm above the dentate line in the right rectal wall. The tumor was mobilized by laparoscopic dissection with a clear safe margin and the specimen was removed from anus. The patient had a smooth recovery and no recurrence was observed 31 months after the procedure. This experience suggests that laparoscopic excision is a safe alternative for rectal GIST, offering the advantage of better visualization of structures and sparing the patient from unnecessary abdominoperineal resections.
胃肠道间质瘤（GISTs）在肛管直肠部位很少见，占所有直肠恶性肿瘤的比例不到0.3%。直肠GISTs的主要治疗方法是完整切除原发肿瘤，切缘显微镜下阴性。在此，我们介绍一种替代方法——腹腔镜辅助下直肠GIST局部切除术。该患者的GIST位于直肠右壁距齿状线4 cm处，大小为5×4×3 cm。通过腹腔镜解剖游离肿瘤，获得清晰的安全切缘，标本经肛门取出。患者恢复顺利，术后31个月未观察到复发。这一经验表明，腹腔镜切除术是直肠GIST的一种安全替代方法，具有能更好地观察组织结构以及避免患者进行不必要的腹会阴联合切除术的优点。
