Our preliminary experience with SILS right hemicolectomy demonstrated the safety of the procedure and its feasibility in malignant colon cancer. Although SILS right hemicolectomy may provide a subjective cosmetic advantage, there was no benefit in the short-term surgical outcomes. SILS is very situational, requires more effort from the surgeon, and may not offer more patient comfort. More experience with SILS and prospective trials are needed to validate it as a more favorable alternative to conventional laparoscopic colectomy.
Gastrointestinal stromal tumors (GISTs) are rarely found in the anorectum and account for less than 0.3% of all rectal malignancies. The major treatment of rectal GISTs is complete resection of the primary tumor with negative microscopic margin. Here, we present an alternative method-laparoscopic-assisted local excision of rectal GIST. The patient had a 5x4x3 cm GIST located 4 cm above the dentate line in the right rectal wall. The tumor was mobilized by laparoscopic dissection with a clear safe margin and the specimen was removed from anus. The patient had a smooth recovery and no recurrence was observed 31 months after the procedure. This experience suggests that laparoscopic excision is a safe alternative for rectal GIST, offering the advantage of better visualization of structures and sparing the patient from unnecessary abdominoperineal resections.
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