Presentation Information
[E6-3]Organ-Sparing Surgery for Rectal GISTs: A Video Demonstration of The Trans-Sacrococcygeal Technique
Aitsariya Mongkhonsupphawan, Woramin Riansuwan (Colorectal Surgery Unit, Department of surgery, Faculty of Medicine Siriraj Hospital, Mahidol University)
Gastrointestinal stromal tumors (GISTs) are uncommon neoplasms in the lower rectum, accounting for fewer than 5 % of all GIST cases. Lower rectal GISTs present unique surgical challenges due to their location in the narrow pelvic space, particularly in achieving negative margins while preserving sphincter function. The optimal surgical approach for these tumors must balance oncological safety with functional outcomes.
We present a video demonstrating the trans-sacrococcygeal approach for excision of a rectal GIST. This technique provides direct access to the retrorectal space while minimizing pelvic dissection. The approach facilitates en-bloc tumor excision with reduced risk of sphincter compromise, making it particularly suitable for low-lying rectal GISTs. Key steps include patient positioning, optimal exposure achieved through sacrococcygeal disarticulation and levator ani muscle incision, meticulous tumor dissection, and pelvic floor reconstruction
This approach serves as an alternative to more radical procedures such as abdominoperineal resection or low anterior resection, emphasizing organ preservation and improved quality of life.
We present a video demonstrating the trans-sacrococcygeal approach for excision of a rectal GIST. This technique provides direct access to the retrorectal space while minimizing pelvic dissection. The approach facilitates en-bloc tumor excision with reduced risk of sphincter compromise, making it particularly suitable for low-lying rectal GISTs. Key steps include patient positioning, optimal exposure achieved through sacrococcygeal disarticulation and levator ani muscle incision, meticulous tumor dissection, and pelvic floor reconstruction
This approach serves as an alternative to more radical procedures such as abdominoperineal resection or low anterior resection, emphasizing organ preservation and improved quality of life.