Transanal Endoscopic Microsurgery (TEM) for rectal GI stromal tumor

Am J Surg. 2021 Jan;221(1):183-186. doi: 10.1016/j.amjsurg.2020.07.013. Epub 2020 Aug 2.


Background: Transanal endoscopic microsurgery (TEM) is effective in treating adenomas and select early rectal cancers. Our objective is to evaluate TEM in treating early rectal GISTs.

Methods: Patients were identified in a prospective database with pathology confirmed rectal GIST prior to TEM over 10 years. Demographic, pathologic, operative and follow-up data was analysed and presented with descriptive statistics.

Results: 7 cases of rectal GIST were treated with TEM with a follow-up time of 31 months (0-71). Median tumor distance from the anal verge was 4 cm (2.5-6) and median tumor size was 3 cm (2-5.7). Negative margins were achieved in 4/7 patients. Those with positive margins were treated with repeat TEM or imatinib. 1 patient had local recurrence successfully treated by TEM.

Conclusions: Overall, TEM is safe for locally excising GISTs. As rectal GISTs are rare, a multicenter registry may better elucidate outcomes with this treatment.

Keywords: GIST; Imatinib; Rectal cancer; TAMIS; TEM.

MeSH terms

  • Aged
  • Aged, 80 and over
  • Female
  • Gastrointestinal Stromal Tumors / surgery*
  • Humans
  • Male
  • Middle Aged
  • Rectal Neoplasms / surgery*
  • Retrospective Studies
  • Transanal Endoscopic Microsurgery*