Trans-Anal Total Mesorectal Excision Technique Feasible for Rectal Gastrointestinal Stromal Tumors
According to the findings of a retrospective study, trans-anal surgery using the trans-anal total mesorectal excision technique is feasible for patients with rectal gastrointestinal stromal tumors (GISTs). Lead author Takahiro Shigaki, MD, National Cancer Center Hospital East, Kashiwa, Chiba, Japan, and colleagues wrote, “Rectal GISTs surgery is often challenging owing to the anatomical constraints of the narrow pelvis and tumor hugeness.”
This retrospective study collected clinical findings, surgical outcomes, pathological outcomes, urinary and anal functions, and prognoses from a prospectively collected database. There were 21 patients included who underwent trans-anal surgery with trans-anal total mesorectal excision for primary rectal GISTs at the National Cancer Center Hospital East between September 2014 and March 2020.
Of all the patients, 7 underwent surgery with 1 team while 14 underwent surgery with 2 teams. There were 19 patients (90.5%) who underwent anus-preserving surgery. In all cases, the urinary tracts were preserved. The pathological negative-margin resection rate was 100%. In the follow-up, there were no instances of local GIST recurrence, and 1 instance (4.8%) of distant metastasis. There was significantly lower blood loss volume (58 mL vs 222 mL; P = .017) and shorter operation time (184 minutes vs 356 minutes; P = .041) for those patients who underwent 2-team surgery compared to 1-team surgery.
Dr Shigaki and colleagues concluded that utilizing the trans-anal total mesorectal excision is feasible for rectal GISTs, and that “two-team surgery may be more advantageous than one-team surgery in terms of operation time and blood loss.”
Source:
Shigaki T, Tsukada Y, Teramura K, et al. Trans-anal surgery with the taTME technique for rectal gastrointestinal stromal tumors: a retrospective study. Int J Colorectal Dis. August 9, 2022, 37(9):1975-1982. doi:10.1007/s00384-022-04233-4
