{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,5,14]],"date-time":"2025-05-14T00:54:31Z","timestamp":1747184071681,"version":"3.40.5"},"reference-count":10,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2021,3,9]],"date-time":"2021-03-09T00:00:00Z","timestamp":1615248000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Colorectal Disease"],"published-print":{"date-parts":[[2021,6]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Aim<\/jats:title><jats:p>We present a para\u2010sacral approach followed by a laparoscopic low anterior resection of gastrointestinal stromal tumours located between the urethra and the low rectum.<\/jats:p><\/jats:sec><jats:sec><jats:title>Method<\/jats:title><jats:p>Case 1 is a 56\u2010year\u2010old male patient whose tumour (37\u00a0\u00d7\u00a028\u00a0mm) was located 3.0\u00a0cm above the anal verge between the anterior wall of the rectum and the urethra; he underwent surgery after 14\u00a0months\u2019 administration of imatinib mesylate (400\u00a0mg\/day). Case 2 is a 68\u2010year\u2010old male patient who presented with dysuria; a tumour (89\u00a0\u00d7\u00a084\u00a0mm) was detected between the urethra and the anterior wall of the low rectum by MRI. He underwent surgery after 5\u00a0months\u2019 administration of imatinib mesylate (400\u00a0mg\/day). In order to perform sphincter\u2010preserving surgery and avoid injury not only to the tumour capsule but also to the urethra, a para\u2010sacral approach followed by laparoscopic low anterior resection was adopted in these patients. Restoration of bowel continuity was done by coloanal anastomosis in case 1 and the double stapling technique in case 2. The postoperative course of the patients was uneventful. In case 2, tumour dissection from the urethra caused injury to the posterior wall of the urethra, which could be repaired easily under direct vision. The urethral catheter was removed after 117 postoperative days, and the diverting stoma was closed after 143 postoperative days.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>The para\u2010sacral approach followed by a laparoscopic low anterior resection of an extraluminal gastrointestinal stromal tumour located between the urethra and anterior wall of the low rectum enables R0 resection of the tumour and an appropriate reconstruction of the rectum.<\/jats:p><\/jats:sec>","DOI":"10.1111\/codi.15597","type":"journal-article","created":{"date-parts":[[2021,2,22]],"date-time":"2021-02-22T20:05:19Z","timestamp":1614024319000},"page":"1579-1583","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Para\u2010sacral approach followed by laparoscopic low anterior resection of a gastrointestinal stromal tumour at the anterior wall of the lower rectum"],"prefix":"10.1111","volume":"23","author":[{"given":"Yuki","family":"Matsumi","sequence":"first","affiliation":[{"name":"Division of Gastrointestinal Surgery Kansai Medical University Hospital Hirakata Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8629-7436","authenticated-orcid":false,"given":"Madoka","family":"Hamada","sequence":"additional","affiliation":[{"name":"Division of Gastrointestinal Surgery Kansai Medical University Hospital Hirakata Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tatsuma","family":"Sakaguchi","sequence":"additional","affiliation":[{"name":"Department of Surgery Kansai Medical University Hirakata Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mitsugu","family":"Sekimoto","sequence":"additional","affiliation":[{"name":"Department of Surgery Kansai Medical University Hirakata Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hiroaki","family":"Kurokawa","sequence":"additional","affiliation":[{"name":"Department of Radiology Kansai Medical University Hospital Hirakata Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hidefumi","family":"Kinoshita","sequence":"additional","affiliation":[{"name":"Department of Urology and Andrology Kansai Medical University Hospital Hirakata Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2021,3,9]]},"reference":[{"key":"e_1_2_10_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ejso.2012.09.004"},{"key":"e_1_2_10_3_1","doi-asserted-by":"publisher","DOI":"10.1007\/s13691-017-0314-x"},{"key":"e_1_2_10_4_1","first-page":"vii49","article-title":"Gastrointestinal stromal tumors: ESMO clinical practice guidelines for diagnosis, treatment and follow\u2010up","volume":"23","author":"ESMO Clinical Practice Guidelines","year":"2012","journal-title":"Ann Oncol"},{"key":"e_1_2_10_5_1","doi-asserted-by":"publisher","DOI":"10.1097\/DCR.0000000000000146"},{"key":"e_1_2_10_6_1","first-page":"1","article-title":"Initial application of transanal endoscopic microsurgery for high\u2010risk lower rectal gastrointestinal stromal tumor after imatinib mesylate neoadjuvant chemotherapy","volume":"96","author":"Liu Q","year":"2017","journal-title":"Medicine"},{"key":"e_1_2_10_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.amjsurg.2005.10.013"},{"key":"e_1_2_10_8_1","doi-asserted-by":"publisher","DOI":"10.1097\/DCR.0000000000001376"},{"key":"e_1_2_10_9_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1463-1318.2008.01489.x"},{"key":"e_1_2_10_10_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10151-017-1641-9"},{"key":"e_1_2_10_11_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10151-017-1615-y"}],"container-title":["Colorectal 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