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Laparoscopic Limited Resection for Duodenal Gastrointestinal Stromal Tumors

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Journal of Gastrointestinal Surgery

Abstract

Background

Laparoscopic surgery may be a suitable treatment for gastrointestinal stromal tumors (GISTs) in terms of oncological feasibility and being minimally invasive. Case series of laparoscopic resection for duodenal GISTs have not been reported in detail, so in this report, the detail of laparoscopic surgeries for duodenal GISTs is summarized.

Methods

This is a single-center retrospective case series of six consecutive patients with duodenal GISTs who underwent laparoscopic limited resection of the duodenum between 2003 and 2019.

Results

Tumors were located within the first portion in three patients, the second portion in two patients, and the third portion in one patient. Median tumor size was 25 mm. Four patients underwent a laparoscopic and endoscopic full-thickness resection with primary closure, one patient underwent a laparoscopic wedge resection, and one patient underwent a laparoscopic segmental duodenectomy with Roux-en-Y gastrojejunostomy. Median blood loss was minimal (10 ml) with median operative time of 2 h, and there were no conversions to open surgery. There were no intraoperative or postoperative complications. All patients underwent curative resection with negative surgical margins, and none had recurrence of their duodenal GISTs. All patients were alive at the end of the follow-up period of 54 months.

Conclusion

Laparoscopic limited resection is a feasible, safe, and ideal treatment procedure for duodenal GISTs in terms of short- and long-term surgical outcomes.

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References

  1. Chung JC, Kim HC, Hur SM. Limited resections for duodenal gastrointestinal stromal tumors and their oncologic outcomes. Surg Today 2016;46:110-116.

    Article  Google Scholar 

  2. Kwon SH, Cha HJ, Jung SW, Kim BC, Park JS, Jeong ID, Lee JH, Nah YW, Bang SJ, Shin JW, Park NH, Kim DH. A gastrointestinal stromal tumor of the duodenum masquerading as a pancreatic head tumor. World J Gastroenterol 2007;13:3396-3399.

    Article  Google Scholar 

  3. Hoeppner J, Kulemann B, Marjanovic G, Bronsert P, Hopt UT. Limited resection for duodenal gastrointestinal stromal tumors: Surgical management and clinical outcome. World J Gastrointest Surg 2013;5:16-21.

    Article  Google Scholar 

  4. Ojima T, Nakamura M, Nakamori M, Takifuji K, Hayata K, Katsuda M, Takei Y, Yamaue H. Laparoscopic and endoscopic cooperative surgery is a feasible treatment procedure for intraluminal gastric gastrointestinal stromal tumors compared to endoscopic intragastric surgery. Surg Endosc 2018;32:351-357.

    Article  Google Scholar 

  5. Sexton JA, Pierce RA, Halpin VJ, Eagon JC, Hawkins WG, Linehan DC, Brunt LM, Frisella MM, Matthews BD. Laparoscopic gastric resection for gastrointestinal stromal tumors. Surg Endosc 2008;22:2583-2587.

    Article  Google Scholar 

  6. Novitsky YW, Kercher KW, Sing RF, Heniford BT. Long-term outcomes of laparoscopic resection of gastric gastrointestinal stromal tumors. Ann Surg 2006;243:738-745.

    Article  Google Scholar 

  7. Yang F, Jin C, Du Z, Subedi S, Jiang Y, Li J, Di Y, Zhou Z, Tang F, Fu D. Duodenal gastrointestinal stromal tumor: clinicopathological characteristics, surgical outcomes, long term survival and predictors for adverse outcomes. Am J Surg 2013;206:360-367.

    Article  Google Scholar 

  8. Tanaka E, Kim M, Lim JS, Choi YY, Saklani A, Noh SH, Hyung WJ. Usefulness of laparoscopic side-to-side duodenojejunostomy for gastrointestinal stromal tumors located at the duodenojejunal junction. J Gastrointest Surg 2015;19:313-318.

    Article  Google Scholar 

  9. Abe N, Hashimoto Y, Takeuchi H, Ohki A, Nagao G, Suzuki Y, Masaki T, Mori T, Sugiyama M. Laparoscopy-assisted full-thickness resection of the duodenum for patients with gastrointestinal stromal tumor with ulceration. Asian J Endosc Surg 2017;10:388-393.

    Article  Google Scholar 

  10. Joensuu H. Risk stratification of patients diagnosed with gastrointestinal stromal tumor. Hum Pathol 2008;39:1411-1419.

    Article  Google Scholar 

  11. Dindo D, Demartines N, Clavien PA. Classification of surgical complications: a new proposal with evaluation in a cohort of 6336 patients and results of a survey. Ann Surg 2004;240:205-213.

    Article  Google Scholar 

  12. Ojima T, Nakamori M, Nakamura M, Hayata K, Katsuda M, Takifuji K, Yamaue H. Laparoscopic and Endoscopic Cooperative Surgery Versus Endoscopic Submucosal Dissection for the Treatment of Low-Risk Tumors of the Duodenum. J Gastrointest Surg 2018;22:935-940.

    Article  Google Scholar 

  13. Navarra G, Pozza E, Occhionorelli S, Carcoforo P, Donini I. One-wound laparoscopic cholecystectomy. Br J Surg 1997;84:695.

    Article  CAS  Google Scholar 

  14. Tien YW, Lee CY, Huang CC, Hu RH, Lee PH. Surgery for gastrointestinal stromal tumors of the duodenum. Ann Surg Oncol 2010;17:109-114.

    Article  Google Scholar 

  15. Kikuchi S, Nishizaki M, Kuroda S, Tanabe S, Noma K, Kagawa S, Shirakawa Y, Kato H, Okada H, Fujiwara T. Nonexposure laparoscopic and endoscopic cooperative surgery (closed laparoscopic and endoscopic cooperative surgery) for gastric submucosal tumor. Gastric Cancer 2017;20:553-557.

    Article  Google Scholar 

  16. Mitsui T, Niimi K, Yamashita H, Goto O, Aikou S, Hatao F, Wada I, Shimizu N, Fujishiro M, Koike K, Seto Y. Non-exposed endoscopic wall-inversion surgery as a novel partial gastrectomy technique. Gastric Cancer 2014;17:594-599.

    Article  Google Scholar 

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Acknowledgments

We acknowledge proofreading and editing by Benjamin Phillis at the Clinical Study Support Center, Wakayama Medical University.

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Authors and Affiliations

  1. Second Department of Surgery, Wakayama Medical University, Wakayama, Japan

    Toshiyasu Ojima, Masaki Nakamura, Keiji Hayata, Junya Kitadani, Masahiro Katsuda, Akihiro Takeuchi, Shinta Tominaga & Hiroki Yamaue

Authors
  1. Toshiyasu Ojima
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  2. Masaki Nakamura
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  3. Keiji Hayata
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  4. Junya Kitadani
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  5. Masahiro Katsuda
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  6. Akihiro Takeuchi
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  7. Shinta Tominaga
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  8. Hiroki Yamaue
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Contributions

Study concept and design: Ojima and Yamaue

Acquisition of data: Ojima, Nakamura, Hayata, Kitadani, Katsuda, Takeuchi, and Tominaga

Analysis and interpretation of data: Ojima, Nakamura, and Hayata

Drafting of the manuscript: Ojima, Nakamura, and Katsuda

Critical revision of the manuscript for important intellectual content: Yamaue

Administrative, technical, and material support: Hayata, Kitadani, and Yamaue

Study supervision: Yamaue

Corresponding author

Correspondence to Toshiyasu Ojima.

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The authors declare that they no conflict of interest.

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Ojima, T., Nakamura, M., Hayata, K. et al. Laparoscopic Limited Resection for Duodenal Gastrointestinal Stromal Tumors. J Gastrointest Surg 24, 2404–2408 (2020). https://doi.org/10.1007/s11605-020-04692-6

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  • DOI: https://doi.org/10.1007/s11605-020-04692-6

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