Diagnosis and treatment of rectal stromal tumor / 中华消化外科杂志

Gastrointestinal stromal tumor (GIST) is a group of tumors which is independently derived from the mesenchymal stem cells of the digestive tract,and consists of undifferentiated or multi-functional spindle or epithelioid cells.Most of the rectal stromal tumor located at the middle or lower part of the rectum,and presented with exogenous growth outside of the rectum cavity.Rectal stromal tumor accounted for 5％ of GIST.Rectal stromal tumor is easily missed or misdiagnosed because of insidious onset and non-typical clinical manifestations.The diagnosis of rectal stromal tumor relies on immunohistochemical staining (CD117 and CD34) and pathological examination.Surgical resection is the first choice for the treatment of local primary rectal stromal tumor.Protection of the integrity of the tumor is important during operation,and routine lymph node dissection is not recommended.Molecular targeted drug mesylate imatinib is adopted in the pre-and postoperative adjuvant therapy.However,due to the rarity of rectal stromal tumor,the treatment strategies need further investigation.

Transposterior approach for local excision of mid-low rectal stromal tumor / 中华消化外科杂志

In spite of the fact that rectal stromal tumor accounts for only 4.2％ of the gastrointestinal stromal tumor,its surgical treatment is still very difficult and challenging due to the special anatomical position of rectum,its complicated anatomical relationship with adjacent organs,and whether the anus be preserved.Local resection of rectal stromal tumor is feasible and reasonable owing to its biological characteristics.However,there are many approaches and methods for local resection and no consensus has been reached.The clinical data of 18 patients with rectal stromal tumor who were treated by local resection via transposterior approach at the Peking Union Hospital from March 2003 to September 2012 were retrospectively analyzed.The surgery not only applies with the oncology treatment principle,but also preserves anus and limits the surgical injury to a large extent.Therefore,it is one of the most ideal surgical methods for the treatment of rectal stromal tumor.