Resection of a rectal gastrointestinal stromal tumour by transanal minimally invasive surgery (TAMIS) after neoadjuvant treatment with Imatinib
Keywords:
Rectal GIST, Neoadjuvant, TAMIS, ImatinibAbstract
The primary treatment of choice for patients with a localised gastro-intestinal stromal tumour (GIST) is complete surgical excision with negative microscopic margins. However, in a space as small as that of the pelvis, complete resection of a large rectal tumour is difficult, and sometimes requires an abdominoperineal amputation. In order to reduce the size of the tumour, as well as the morbidity associated with more aggressive surgical procedures, neoadjuvant treatment with Imatinib was introduced in this case, with the response being monitored by of endoscopic ultrasound. The response obtained by reducing the tumour volume modified the strategy, making it possible to obtain a satisfactory resection using transanal minimally invasive surgery (TAMIS), preserving the anal sphincters and avoiding the genitourinary morbidity associated with the mesorectal excision.
Author Biographies
Fernando Fernández López, Hospital Clínico Universitario de Santiago
Unidad de Coloproctología, Servicio de Cirugía General y Aparato Digestivo, Hospital Clínico Universitario de Santiago, Santiago de Compostela, La Coruña España
María Jesús Ladra Gonzáles, Hospital Clínico Universitario de Santiago
Unidad de Coloproctología, Servicio de Cirugía General y Aparato Digestivo, Hospital Clínico Universitario de Santiago, Santiago de Compostela, La Coruña España
Francisco González Rodríguez, Hospital Clínico Universitario de Santiago
Servicio de Cirugía General y Digestiva, Hospital Clínico Universitario de Santiago, Santiago de Compostela, La Coruña España
Manuel Paz Novoa, Hospital Clínico Universitario de Santiago
Unidad de Coloproctología, Servicio de Cirugía General y Aparato Digestivo, Hospital Clínico Universitario de Santiago, Santiago de Compostela, La Coruña España
Jesús Paredes Cotoré, Hospital Clínico Universitario de Santiago
Unidad de Coloproctología, Servicio de Cirugía General y Aparato Digestivo, Hospital Clínico Universitario de Santiago, Santiago de Compostela, La Coruña, España
Manuel Bustamante Montalvo, Hospital Clínico Universitario de Santiago
Jefe de Servicio de Cirugía General y Digestiva, Hospital Clínico Universitario de Santiago, Santiago de Compostela, La Coruña, España
References
Saund MS, Demetri GD, Ashley SW. Gastrointestinal stromal tumors (GISTs). Curr Opin Gastroenterol. 2004;20:89-94.
https://doi.org/10.1097/00001574-200403000-00007
DeMatteo RP, Lewis JJ, Leung D, Mudan SS, Woodruff JM, Bren-nan MF, et al. Two hundred gastrointestinal stromal tumors.Recurrence patterns and prognosis factors for survival. Ann Surg. 2000;231:51-8.
https://doi.org/10.1097/00000658-200001000-00008
Kantawala KP, Sonavane SK, Menias CO, Pai RK. Atypical tumors of the rectum with pathologic correlation. Curr Probl Diagn Radiol. 2011;40:198-207.
https://doi.org/10.1067/j.cpradiol.2011.01.001
Blay JY, Bonvalot S, Casali P, Choi H, Debiec-Richter M, Dei Tos AP, et al. Consensus meeting for the management of gastrointestinal stromal tumors. Report of the GIST Consensus Conference of 20-21 March 2004, under the auspices of ESMO. Ann Oncol.2005;16:566-78.
https://doi.org/10.1093/annonc/mdi127
Poveda A, Artigas V, Casado A, Cervera J, García del Muro X, López-Guerrero JA, et al. Guía de práctica clínica en los tumores estromales gastrointestinales (GIST): Actualización 2008. Cir Esp. 2008;84 Supl 1:1-12.
National Comprehensive Cancer Network. NCCN Clinical Prac-tice Guidelines in Oncology. Soft Tissue Sarcoma. Version 2.2017, 02/08/17 © National Comprehensive Cancer Network, Inc. 2017. http://www.nccn.org/professionals/physiciangls/pdf/sarcoma.pdf
The ESMO European Sarcoma Network Working Group. Gastroin- testinal stromal tumours: ESMO clinical practice guidelines for diagnosis, treatment and follow-up. Ann Oncol. 2014;25 Suppl 3:iii21-6.
https://doi.org/10.1093/annonc/mdu255
Joensuu H, Vehtari A, Riihimaki T, Nishida T, Steigen SE, Brabec P, et al. Risk of recurrence of gastrointestinal stromal tumour after surgery: An analysis of pooled population-based cohorts.Lancet Oncol. 2012;13:265-74.
https://doi.org/10.1016/S1470-2045(11)70299-6
Fernández JA, Parrilla P. Tratamiento quirúrgico del GIST avan-zado en la era del imatinib. Cir Esp. 2009;86:3-12.
https://doi.org/10.1016/j.ciresp.2008.09.023
Kyo K, Azuma M, Okamoto K, Nishiyama M, Shimamura T, Maema A, et al. Neoadjuvantimatinib treatment and laparoscopic anus-preserving surgery for a large gastrointestinal stromal tumor of the rectum. World J Surg Oncol. 2016;14:68.
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