Gastrointestinal stromal tumors of the stomach: The role of laparoscopic resection. Single-centre experience of 38 cases

Mario Valle, Orietta Federici, Fabio Carboni, Silvia Carpano, Michele Benedetti, Alfredo Garofalo

Research output: Contribution to journalArticlepeer-review

Abstract

Introduction: Laparoscopic resection is considered the gold standard of treatment only for small gastric gastrointestinal stromal tumor (GIST). Materials and Methods: Between January 2004 and September 2012, 38 consecutive gastric GISTs were operated on by laparoscopic approach, without conversions. Thirty-five cases were primary GISTs and three were bleeding GISTs with hepatic metastases non-responding to conservative therapy treated by emergency surgery. Results: Median tumor size was 3.63 cm (1.8-17 cm). In two cases tumor size was 10 cm in two cases. In two cases, localization was in the cardia, fundus in ten cases, lesser curve in 11 cases, greater curve in 12 cases, and antrum in three cases. We performed 24 wedge resections, eight transgastric resections and six antrectomies. An Endo-GIA™ was used in 25 cases, and a manual laparoscopic reconstruction with extramucosal suture was performed in 13 cases. No postoperative mortality and morbidity was observed. The routine use of laparoscopy allowed us to perform resections in 100 % of cases, even in those where preoperative imaging suggested an open approach according to the current guidelines. Conclusions: The use of a pre-resection endobag avoids spillage and seeding, thus increasing the possibility of resection. In conclusion, we consider the laparoscopic approach as mandatory in all cases, always considering the possibility of converting to the open technique when necessary.

Original languageEnglish
Pages (from-to)1040-1047
Number of pages8
JournalSurgical Endoscopy and Other Interventional Techniques
Volume28
Issue number3
DOIs
Publication statusPublished - 2014

Keywords

  • Gastric gist
  • Laparoscopy
  • Surgery

ASJC Scopus subject areas

  • Surgery
  • Medicine(all)

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