Minimally invasive organ-preserving surgery for rectal gastrointestinal stromal tumour: Report of two cases with long-term follow-up

Rectal gastrointestinal stromal tumours (GISTs) are uncommon and pose technical challenges due to their deep pelvic location and proximity to the anal sphincter complex. Radical resections, although traditionally preferred, often result in significant morbidity. We describe two cases of rectal GIST successfully managed by transanal minimally invasive surgery (TAMIS). One patient received neoadjuvant imatinib to downsize the tumour before excision. Full-thickness transanal tumour excision was achieved without rupture in both cases, with primary rectal wall closure. At 5 and 4 years of follow-up, respectively, both patients remain recurrence-free with full continence. TAMIS represents a safe, oncologically sound, organ-preserving approach for selected rectal GISTs.