Laparoscopic Inter-sphincteric Resection following Neoadjuvant Imatinib Mesylate Therapy for the Treatment of Rectal GIST with Anal Preservation—A Case Report—
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- SHIMOMURA Osamu
- Department of Surgery, Faculty of Medicine, University of Tsukuba
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- ENOMOTO Tsuyoshi
- Department of Surgery, Faculty of Medicine, University of Tsukuba
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- ITOH Masaaki
- Department of Colorectal and Pelvic Surgery, National Cancer Center Hospital East
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- TAMURA Takafumi
- Department of Surgery, Faculty of Medicine, University of Tsukuba
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- OHKOHCHI Nobuhiro
- Department of Surgery, Faculty of Medicine, University of Tsukuba
Bibliographic Information
- Other Title
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- 術前補助療法後に腹腔鏡下ISRを施行した直腸GISTの1例
- 症例 術前補助療法後に腹腔鏡下ISRを施行した直腸GISTの1例
- ショウレイ ジュツゼン ホジョ リョウホウ ゴ ニ フククウキョウ カ ISR オ シコウ シタ チョクチョウ GIST ノ 1レイ
- Laparoscopic Inter-sphincteric Resection following Neoadjuvant Imatinib Mesylate Therapy for the Treatment of Rectal GIST with Anal Preservation—A Case Report—
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Description
A 63-year-old man was admitted to our hospital with the chief complaint of constipation. A rectal digital examination revealed an elastic hard mass located in the posterior wall of the rectum. Colonoscopy showed a submucosal tumor measuring 60 mm in diameter in the lower rectum above the dentate line, near the anal canal. Dynamic CT revealed a rectal tumor measuring 61×59mm in size displacing the lower rectum forward. There was no evidence of either lymph node or distant metastasis. MRI showed the membrane-covered tumor extending to the levator ani muscle bilaterally. A biopsy specimen was positive for CD34 and c-kit (CD117). The Ki-67/MIB-1 index of the tumor cells was 10.7%. Based on the findings, the tumor was diagnosed as a rectal GIST. The patient desired anal preservation, therefore, preoperative imatinib mesylate (IM) therapy was selected. IM was administered at the dose of 400 mg once daily. After 6 months of IM therapy, CT and MRI revealed a decrease of the maximal diameter of the tumor to 45 mm (33% reduction). Seven months after the initial diagnosis, laparoscopic inter-sphincteric resection (ISR) was performed, including partial external sphincter resection and temporary ileostomy, and the anal sphincter muscle was successfully preserved.
Journal
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- Nihon Rinsho Geka Gakkai Zasshi (Journal of Japan Surgical Association)
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Nihon Rinsho Geka Gakkai Zasshi (Journal of Japan Surgical Association) 76 (2), 338-343, 2015
Japan Surgical Association
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Details 詳細情報について
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- CRID
- 1390001204850491136
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- NII Article ID
- 130005095221
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- NII Book ID
- AA11189709
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- ISSN
- 18825133
- 13452843
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- NDL BIB ID
- 030763924
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- Text Lang
- ja
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- Data Source
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- JaLC
- NDL Search
- Crossref
- CiNii Articles
- OpenAIRE
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- Abstract License Flag
- Disallowed