Our Experience Regarding the Association Between Gastrointestinal Stromal Tumor and Bariatric Surgery: a Response to a Letter “Gastrointestinal Stromal Tumor After Laparoscopic Sleeve Gastrectomy: Be Awake Before, During, and After a Bariatric Procedure”
- 13 Downloads
We would like to express gratitude to Bilecik T. et al. and to Chiappetta S. et al. for their articles regarding the gastrointestinal stromal tumor (GIST) as a bariatric surgery incidental finding [1, 2]. By these means, we would like to share our experience regarding this relationship and, as already mentioned, to try as a surgical team to be aware and even search the connection between them.
The strong prevalence of the cells of Cajal at the gastric level, specifically in the fundus [3, 4, 5] so as the quick development of bariatric surgery, derives in a higher incidence of these diagnoses, either during or postoperatively through the biopsy results. Worldwide references talk about a prevalence between 0.3 and 1.2% of GIST in the biopsy specimen [6, 7, 8, 9, 10, 11, 12, 13] and 35 described observations [1, 2, 12, 14, 15, 16, 17, 18].
Compliance with Ethical Standards
Conflict of Interest
The authors declare that they have no conflict of interest.
Ethical Statement and Consent Statement
For this type of study, formal consent is not required.
- 1.Bilecik T, Karateke F, Cetinkunar S, et al. Gastrointetinal stromal tumor after laparoscopic sleeve gastrectomy: be awake before, during and after a bariatric procedure. Obes Surg. 2018;28(6):1785–6. https://doi.org/10.1007/s11695-018-3234-8.
- 3.Agaimy A, Wünsch PH, Hofstaedter F, et al. Minute sclerosing stromal tumors (GIST tumorlets) are common in adults and frequently show KIT mutations. Am J Surg Pathol. 2007;31(1):113–20. https://doi.org/10.1097/01.pas.0000213307.05811.f0.
- 4.Abraham SC, Krasinskas AM, Hofstetter WL, et al. “Seedling” mesenchymal tumors (gastrointestinal stromal tumors and leiomyomas) are common incidental tumor in esophagogastric junction. Am J Surg Pathol. 2007;31(11):1629–35. https://doi.org/10.1097/PAS.0b013e31806ab2c3.
- 5.Yun HY, Sung R, Kim YC, et al. Regional distribution of interstitial cells of Cajal (ICC) in human stomach. Korean J Physiol Pharmacol. 2010;14(5):317–24. https://doi.org/10.4196/kjpp.2010.14.5.317.
- 6.Yuval JB, Khalaileh A, Abu-Gazala M, et al. The true incidence of gastric GIST- a study based on morbidly obese patients undergoing sleeve gastrectomy. Obes Surg. 2014;24(12):2134–7. https://doi.org/10.1007/s11695-014-1336-5.
- 7.Crouthamel MR, Kaufman JA, Billing JP, et al. Incidental gastric mesenchymal tumors identified during laparoscopic sleeve gastrectomy. Surg Obes Relat Dis. 2015;11(5):1025–8. https://doi.org/10.1016/j.soard.2015.06.004.
- 9.Lauti M, Gormack SE, Thomas JM, et al. What does the excised stomach from sleeve gastrectomy tells us? Obes Surg. 2016;26(4):839–42. https://doi.org/10.1007/s11695-015-1832-2.
- 10.Kinsinger LA, Garber JC, Whipple O. A review of sleeve gastrectomy specimen histopathology. Am Surg 2016;82(11):1101–1104.Google Scholar
- 11.Safaan T, Bashash M, El Ansari W, et al. Histopathological changes in laparoscopic sleeve gastrectomy specimens. Obes Surg. 2017;27(7):1741–9. https://doi.org/10.1007/s11695-016-2525-1.
- 12.Viscido G, Signorini F, Navarro L, et al. Incidental finding of gastrointestinal stromal tumor during laparoscopic sleeve gastrectomy in obese patients. Obes Surg. 2017;27(8):2022–5. https://doi.org/10.1007/s11695-017-2583-z.
- 13.Chiappetta S, Theodoridou S, Stier C, et al. Incidental finding of GIST during obesity surgery. Obes Surg. 2015;25(3):579–83. https://doi.org/10.1007/s11695-015-1571-4.
- 14.Wang Y, Liu J. Laparoscopic sleeve gastrectomy in the treatment of gastrointestinal tumors in morbid obese patients. BMJ Case Rep. 2009;2009:bcr0620080204. https://doi.org/10.1136/bar06.2008.0204.
- 15.Beltran MA, Pujado B, Méndez PE, et al. Gastric gastrointestinal tumor (GIST) incidentally found and resected during laparoscopic sleeve gastrectomy. Obes Surg. 2010;20(3):393–6. https://doi.org/10.1007/s11695-009-0009-2.
- 18.Alshlwi S, El Bahrawy A, Alamri H and al. Laparoscopic transgastric resection of gastric submucosal tumor near esophagogastric junction with concomitant sleeve gastrectomy: a video case report. Obes Surg 2017;27(2):552–553, DOI: https://doi.org/10.1007/s11695-016-2450-3.
- 19.Chevallier JM, Pattou F. Chirurgie de l’obésité. 1th ed. Paris : Arnette ; 2004.Google Scholar
- 20.Sanchez BR, Morton JM, Curet MJ, et al. Incidental finding of gastrointestinal stromal tumors (GISTs) during laparoscopic gastric bypass. Obes Surg. 2005;15(10):1384–8. https://doi.org/10.1381/096089205774859326.
- 21.Finnell CW, Madan AK, Ternovits CA, et al. Unexpected pathology during laparoscopic bariatric surgery. Surg Endosc. 2007;21(6):867–9. https://doi.org/10.1007/s00464-006-9079-6.
- 23.De Roover A, Detry O, De Leval L, et al. Report of two cases of gastric cancer after bariatric surgery: lymphoma of the bypassed stomach after Roux-en-Y gastric bypass and gastrointestinal stromal tumor (GIST) after vertical banded gastroplasty. Obes Surg. 2006;16(7):928–31. https://doi.org/10.1381/096089206777822142.
- 25.Goettsch WG, Bos SD, Breekvedlt-Postma N, et al. Incidence of gastrointestinal stromal tumours is underestimated: results of a nation-wide study. Eur J Cancer. 2005;41(18):2868–72. https://doi.org/10.1016/j.ejca.2005.09.009.