ArticleSurgical endoscopy2026
Transanal endoscopic microsurgery (TEM) for rectal GI stromal tumour.
Article in Surgical endoscopy, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
backgroundRectal gastrointestinal stromal tumours (GIST) are uncommon and technically challenging to treat due to the confined pelvic anatomy and proximity to the anal sphincter complex. The oncological goal of surgery is R0 resection, but radical procedures often compromise function. Transanal endoscopic microsurgery (TEM/TEO) provides stable exposure and precise full-thickness excision, offering the possibility of organ preservation. The role of tumour size and neoadjuvant imatinib in enabling local excision remains under investigation.
methodsWe conducted a retrospective single-centre study of all consecutive patients undergoing TEM/TEO for rectal GIST between January 2007 and May 2023. Clinicopathological data, operative outcomes, postoperative course, and follow-up were analysed. Disease-free survival (DFS) and overall survival (OS) were estimated with the Kaplan-Meier method.
resultsThirteen patients were included. Median age was 55 years (IQR 48-69), 69.2% were male, and median BMI was 26.1 kg/m
conclusionTEM/TEO achieved a high rate of R0 resection with organ preservation in this small single-centre series of rectal GIST. Tumour size alone should not be considered an absolute contraindication when en-bloc excision without rupture and negative margins are technically achievable. Neoadjuvant imatinib may facilitate local excision in selected borderline cases, but our experience is limited and larger multicentre registries are required to better define selection criteria and long-term outcomes.
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