Endoscopy 2025; 57(S 02): S438
DOI: 10.1055/s-0045-1806122
Abstracts | ESGE Days 2025
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Efficacy and Safety of Endoscopic resection for Rectal GISTs Invading the Dentate Line: A Feasibility Study

S J Kim
1   Department of Internal Medicine, College of Medicine, Chosun University, Gwangju, Republic of Korea
,
L Min Hyuk
1   Department of Internal Medicine, College of Medicine, Chosun University, Gwangju, Republic of Korea
,
J Lee
1   Department of Internal Medicine, College of Medicine, Chosun University, Gwangju, Republic of Korea
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Aims Gastrointestinal stromal tumors (GISTs) located at the distal rectum near the dentate line present significant surgical challenges and a high risk of compromising anal sphincter function. This study evaluates the feasibility, effectiveness, and safety of endoscopic resection as a minimally invasive alternative for managing such tumors [1] [2] [3].

Methods We retrospectively reviewed the medical records of patients who underwent endoscopic resection for rectal GISTs at or near the dentate line from January 2015 to December 2023. We assessed the outcomes in terms of procedural efficacy, safety, and long-term prognosis, and compared these results with a control group treated for epithelial lesions of similar characteristics.

Results The study included 10 patients with rectal GISTs treated via endoscopic resection. The tumors had an average size of 34.5±16.4 mm. The average duration of the procedures was 88.7±45.24 minutes, and the resection speed was 15.44±10.85 mm²/min. The en bloc and complete resection rates were both 100%. For comparative analysis,During the same period, patients who underwent ESD for rectal epithelial lesions were matched 1:2 by age and sex for comparative analysis. There were no differences in patient basal characteristics and procedure time, en bloc resection rate, or complete resection rate. In terms of safety, there were no significant differences in delayed bleeding (10% vs. 30%, p=0.372), perforation (0% vs. 0%), or PECS (10% vs. 20%). One recurrence was noted in the GIST group during a mean follow-up of 33 months.

Conclusions Endoscopic resection is a viable and safe alternative for the treatment of rectal GISTs affecting the dentate line, offering effective tumor control with minimal risk of complications and excellent preservation of anal function. These findings underscore the potential of ESD as a first-line treatment in selected cases. Future large-scale, prospective studies are necessary to further validate these outcomes and refine patient selection criteria.



Publication History

Article published online:
27 March 2025

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