Abstract
Laparoscopic wedge resection of the stomach (LWS) has become the treatment of choice for patients with benign gastric tumors. The technical consideration and long-term follow-up data of LWS for gastrointestinal stromal tumors (GISTs) of the stomach are limited. We present our experience of 28 LWSs for gastric GISTs with a mean follow-up of 43 months. From October 1995 to December 2002, we successfully performed 28 LWSs for 29 patients with GISTs of the stomach, and one patient needed conversion to laparotomy because of suspected bowel injury when establishing pneumoperitoneum. Patient demographics, perioperative parameters, and outcomes of the 28 patients were assessed retrospectively. The tumors were located in the upper third of the stomach in 13 patients, in the middle third, in eight patients, and in the lower third, in seven patients. The mean size of tumors was 3.4 ± 1.6 cm in diameter. The duration of operation ranged from 95 to 390 minutes: 189.6 ± 79.5 minutes with the stapler method and 194.3 ± 50.5 minutes with the hand-sewn method (P = 0.8870). No blood transfusion was given in the perioperative period in all cases. Cholecystectomy in three patients and repair of hiatal hernia in one patient were performed during the same operation. The oral intake was restored at the third to fourth postoperative days. The hospital stay ranged from 3 to 11 days (mean, 6.7 ± 1.8 days). The follow-up period ranged from 12 to 95 months (mean, 43.3 ± 23.5 months, median 42 months). There has been no evidence of tumor recurrence, including one patient with microscopic invasion of section margin. LWS can be performed safely with a satisfactory remission rate for patients with gastric stromal cell tumors.
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References
Hirota S, Isozaki K, Moriyama Y, et al. Gain-of-function mutations of c-kit in human gastrointestinal stromal tumors. Science 1998;279:577–580.
Rubin BP, Fletcher JA, Fletcher CDM. Molecular insights into the histogenesis and pathogenesis of gastrointestinal stromal tumors. Int J Surg Pathol 2000;8:5–10.
Miettinen M, Sarlomo-Rikala M, Lasota J. Gastrointestinal stromal tumors: Recent advances in understanding of their biology. Hum Pathol 1999;30:1213–1230.
Strickland L, Letson GD, Muro-Cacho CA. Gastrointestinal stromal tumors. Cancer Control 2001;8:252–261.
Tagaya N, Mikami H, Kubota K. Laparoscopic resection of gastrointestinal mesenchymal tumors located in the upper stomach. Surg Endosc 2004;18:1469–1474.
Heinrich MC, Corless CL, Demetri GD, et al. Kinase mutation and imatinib response in patients with metastatic gastrointestinal stromal tumor. J Clin Oncol 2003;21:4342–4349.
Emory TS, Sobin LH, Lukes L, Lee DH, O’Leary TJ. Prognosis of gastrointestinal smooth muscle (stromal) tumors: Dependence on anatomic site. Am J Surg Pathol 1999;23:82–87.
Cheng HL, Lee WJ, Lai IR, Yuan RH, Yu SC. Laparoscopic wedge resection of benign gastric tumor. Hepatogastroenterology 1999;46:2100–2104.
Basso N, Rosato P, De Leo A, et al. Laparoscopic treatment of gastric stromal tumors. Surg Endosc 2000;14:524–526.
Fletcher C, Berman J, Coreless C, et al. Diagnosis of gastrointestinal stromal tumors: A consensus approach. Hum Pathol 2002;33:459–465.
Lai IR, Hu RH, Chang KJ. Is imatinib justified as an adjuvant chemotherapy for patients with recurrent gastrointestinal stromal tumors. Hepatogastroenterology 2005;52:826–828.
Bouillot JL, Bresler L, Fagniez PL, et al. Laparoscopic resection of benign submucosal gastric tumors-A report of 65 cases. Gastroenterol Clin Biol 2003;27:272–276.
DeMatteo RP, Lewis JJ, Leung D, Mudan SS, Woodruff JM, Brennan MF. Two hundred gastrointestinal stromal tumors: Recurrence patterns and prognostic factors for survival. Ann Surg 2000;231:51–58.
Hepworth CC, Mensies D, Motson RW. Minimally invasive surgery for posterior gastric stromal tumors. Surg Endosc 2000;14:349–353.
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Lai, IR., Lee, WJ. & Yu, SC. Minimally invasive surgery for gastric stromal cell tumors: intermediate follow-up results. Journal of Gastrointestinal Surgery 10, 563–566 (2006). https://doi.org/10.1016/j.gassur.2005.08.028
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DOI: https://doi.org/10.1016/j.gassur.2005.08.028