Endo Yoki, Fukuoka Tatsunari, Ozawa Shintaro, Ishidate Takemi, Yonemitsu Ken, Seki Yuki, Kasashima Hiroaki, Miki Yuichiro, Yoshii Mami, Tamura Tatsuro, Shibutani Masatsune, Toyokawa Takahiro, Lee Shigeru, Maeda Kiyoshi
Department of Gastroenterological Surgery, Osaka Metropolitan University Graduate School of Medicine, 1-4-3, Asahimachi, Abeno-Ku, Osaka City, Osaka, 545-8586, Japan.
Surg Case Rep. 2024 Sep 10;10(1):213. doi: 10.1186/s40792-024-02007-4.
Rectal gastrointestinal stromal tumors (GISTs) complicate surgical approaches because of their anatomical position. We herein report a patient with rectal GIST on the anterior wall of the lower rectum, hat was successfully resected using a transperineal approach.
This report describes a unique case of a 73-year-old man who was diagnosed with rectal GIST on the anterior wall of the lower rectum. The tumor was located within 3 cm of the anal verge, a location that would require highly invasive surgery. A transperineal approach was planned to preserve the anal function. Under general anesthesia, the patient was placed in a lithotomy position and a Mercedes-Benz incision was made in the perineum. Excision of the tumor was performed. The post-operative course was uneventful, and the patient remained free from recurrence.
This case highlights the importance of performing minimally invasive and safe surgery. With some surgical refinements, a transperineal approach may be an option for surgical procedures in patients with rectal GIST on the anterior wall of the lower rectum.
直肠胃肠道间质瘤（GISTs）因其解剖位置使手术方式复杂化。我们在此报告一例位于直肠下段前壁的直肠GIST患者，该患者通过经会阴途径成功切除肿瘤。
本报告描述了一例独特病例，一名73岁男性被诊断为直肠下段前壁的直肠GIST。肿瘤位于距肛缘3厘米以内，该位置需要进行高侵袭性手术。计划采用经会阴途径以保留肛门功能。在全身麻醉下，患者取截石位，在会阴处做梅赛德斯 - 奔驰切口。进行了肿瘤切除。术后过程顺利，患者无复发。
该病例突出了实施微创和安全手术的重要性。通过一些手术改进，经会阴途径可能是直肠下段前壁直肠GIST患者手术的一种选择。
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