PURPOSE: Gastrointestinal stromal tumors (GISTs) should be surgically resected, even those smaller than 5 cm in size, which is the threshold of clinical malignancy for submucosal tumors (SMTs) in the gastrointestinal tract. This study reviewed the use of laparoscopic surgery for gastric partial resection of GISTs or SMTs that were suspected to be GISTs. METHODS: Eighteen patients underwent laparoscopic partial resection of the stomach for GISTs or SMTs. The tumor location was confirmed by intraluminal endoscopy. One-half of the circumference around the tumor was dissected, and the tumor was turned toward the abdominal cavity. The nonresected part of the tumor and the edge of the incision line was lifted up using forceps, and the incision line was closed using laparoscopic stapling devices. RESULTS: Two cases were diagnosed as GIST by endoscopic biopsy. Six patients underwent endoscopic ultrasound-guided fine-needle aspiration biopsy (EUS-FNAB) examinations, which diagnosed five GISTs. There were 18 tumors smaller than 5 cm, including 10 GISTs, 4 leiomyomas, 3 schwannomas, and one heterotopic pancreas. CONCLUSIONS: Endoscopic ultrasound-guided FNAB is recommended for definite preoperative diagnosis of histopathologically unknown SMTs to determine the indications for surgery. The laparoscopic approach with the assistance of endoscopy is useful for improving the curability, with minimal invasiveness for the partial resection of GISTs.
PURPOSE:Gastrointestinal stromal tumors (GISTs) should be surgically resected, even those smaller than 5 cm in size, which is the threshold of clinical malignancy for submucosal tumors (SMTs) in the gastrointestinal tract. This study reviewed the use of laparoscopic surgery for gastric partial resection of GISTs or SMTs that were suspected to be GISTs. METHODS: Eighteen patients underwent laparoscopic partial resection of the stomach for GISTs or SMTs. The tumor location was confirmed by intraluminal endoscopy. One-half of the circumference around the tumor was dissected, and the tumor was turned toward the abdominal cavity. The nonresected part of the tumor and the edge of the incision line was lifted up using forceps, and the incision line was closed using laparoscopic stapling devices. RESULTS: Two cases were diagnosed as GIST by endoscopic biopsy. Six patients underwent endoscopic ultrasound-guided fine-needle aspiration biopsy (EUS-FNAB) examinations, which diagnosed five GISTs. There were 18 tumors smaller than 5 cm, including 10 GISTs, 4 leiomyomas, 3 schwannomas, and one heterotopic pancreas. CONCLUSIONS: Endoscopic ultrasound-guided FNAB is recommended for definite preoperative diagnosis of histopathologically unknown SMTs to determine the indications for surgery. The laparoscopic approach with the assistance of endoscopy is useful for improving the curability, with minimal invasiveness for the partial resection of GISTs.
Authors: S Hirota; K Isozaki; Y Moriyama; K Hashimoto; T Nishida; S Ishiguro; K Kawano; M Hanada; A Kurata; M Takeda; G Muhammad Tunio; Y Matsuzawa; Y Kanakura; Y Shinomura; Y Kitamura Journal: Science Date: 1998-01-23 Impact factor: 47.728
Authors: Christopher D M Fletcher; Jules J Berman; Christopher Corless; Fred Gorstein; Jerzy Lasota; B Jack Longley; Markku Miettinen; Timothy J O'Leary; Helen Remotti; Brian P Rubin; Barry Shmookler; Leslie H Sobin; Sharon W Weiss Journal: Hum Pathol Date: 2002-05 Impact factor: 3.466
Authors: George D Demetri; Robert S Benjamin; Charles D Blanke; Jean-Yves Blay; Paolo Casali; Haesun Choi; Christopher L Corless; Maria Debiec-Rychter; Ronald P DeMatteo; David S Ettinger; George A Fisher; Christopher D M Fletcher; Alessandro Gronchi; Peter Hohenberger; Miranda Hughes; Heikki Joensuu; Ian Judson; Axel Le Cesne; Robert G Maki; Michael Morse; Alberto S Pappo; Peter W T Pisters; Chandrajit P Raut; Peter Reichardt; Douglas S Tyler; Annick D Van den Abbeele; Margaret von Mehren; Jeffrey D Wayne; John Zalcberg Journal: J Natl Compr Canc Netw Date: 2007-07 Impact factor: 11.908
Authors: Sebastian H Lamm; Daniel C Steinemann; Georg R Linke; Dietmar Eucker; Thomas Simon; Andreas Zerz; Reinhard Stoll Journal: Surg Endosc Date: 2014-12-25 Impact factor: 4.584
Authors: Sabha Ganai; Vivek N Prachand; Mitchell C Posner; John C Alverdy; Eugene Choi; Mustafa Hussain; Irving Waxman; Marco G Patti; Kevin K Roggin Journal: J Gastrointest Surg Date: 2012-12-08 Impact factor: 3.452