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Laparoscopic Wedge Resection for Gastrointestinal Stromal Tumors of the Stomach: Initial Experience

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Abstract

Purpose

Surgery for gastrointestinal stromal tumors (GIST) of the stomach is now frequently performed using a laparoscopic approach. We investigated the feasibility and effectiveness of laparoscopy in the management of GIST of the stomach.

Methods

We reviewed the records of 12 consecutive patients who underwent laparoscopic surgery for GIST between April 2000 and April 2004, and compared their short-term outcomes with those of patients who underwent open surgery. All laparoscopic wedge resections were done using stapling devices and 3–4 trocars, often with the aid of intraoperative gastroscopy. We examined all patients preoperatively using various diagnostic modalities, including endoscopic ultrasonography-guided fine-needle aspiration (EUS-FNA). A laparoscopic approach was not indicated if the tumor was located near the cardia or pylorus or if it was ≧5 cm in diameter.

Results

A specific diagnosis of GIST was obtained preoperatively by EUS-FNA in 10 of the 12 patients. The median diameter of the lesion was 2.7 cm (range, 1.5–4.8 cm). Although intraoperative complications were encountered in two patients, conversion to open surgery was not required, and we were able to perform complete tumor excision with negative surgical margins in all patients. The median operative time was 100 min (range, 65–180 min), similar to that for open surgery. First flatus was passed earlier, and the interval to resuming oral intake was shorter than after open surgery. No major postoperative complications such as leakage developed, and the median postoperative hospital stay was 7 days (range, 5–12 days). All diagnoses made by EUS-FNA were confirmed by immunohisto-pathological evaluation of resected specimens.

Conclusion

Laparoscopic wedge resection is a feasible treatment option for GISTs of the stomach if the lesion is <5 cm in diameter.

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Authors and Affiliations

  1. Department of Gastroenterological Surgery, Aichi Cancer Center Hospital, Nagoya, Japan

    Yoshinari Mochizuki, Seiji Ito, Yoshitaka Yamamura & Tomoyuki Kato

  2. Department of Surgery II, Nagoya University School of Medicine, 65 Tsurumai-cho, Showa-ku, Nagoya, 466-8550, Japan

    Yasuhiro Kodera & Michitaka Fujiwara

  3. Department of Gastroenterology, Aichi Cancer Center Hospital, Nagoya, Japan

    Akira Sawaki & Kenji Yamao

Authors
  1. Yoshinari Mochizuki
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  2. Yasuhiro Kodera
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  3. Michitaka Fujiwara
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  4. Seiji Ito
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  5. Yoshitaka Yamamura
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  6. Akira Sawaki
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  7. Kenji Yamao
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  8. Tomoyuki Kato
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Mochizuki, Y., Kodera, Y., Fujiwara, M. et al. Laparoscopic Wedge Resection for Gastrointestinal Stromal Tumors of the Stomach: Initial Experience. Surg Today 36, 341–347 (2006). https://doi.org/10.1007/s00595-005-3164-7

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  • DOI: https://doi.org/10.1007/s00595-005-3164-7

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