Original Communication| Volume 147, ISSUE 4, P516-520, April 2010

Tailored laparoscopic resection for suspected gastric gastrointestinal stromal tumors

Published:December 11, 2009DOI:


      The aim of the present study was to evaluate the long-term outcomes of tailored laparoscopic resections for suspected gastric gastrointestinal stromal tumors (GISTs) based on the tumor size, location, and growth morphology.


      Between February 1994 and April 2009, 64 patients undergoing gastric resections of suspected gastric GISTs were identified in a prospectively collected database. Medical records were reviewed for patient demographics, perioperative outcomes, and follow-up.


      Forty-five patients underwent attempted laparoscopic resections, with 44 completed laparoscopically. Twenty-eight neoplasms were located in the upper third of the stomach (including 6 neoplasms at the esophagogastric junction), 9 in the middle third, and 8 in the lower third (including 4 prepyloric neoplasms). Laparoscopic approaches included 35 exogastric (3 single incision access) and 10 transgastric approaches. Median operating time was 100 min (range, 30–240), and blood loss was 5 ml (range, 1–80). Median tumor size and operative margin were 32 mm (range, 16–74) and 7 mm (range, 1–20), respectively. One patient was converted to an open, pylorus-preserving gastrectomy. One patient developed a complication. The histopathologic risk assessment classifications of 37 GISTs were 2 very low, 26 low, 7 intermediate, and 2 high risk. Although 1 patient developed a local recurrence after intragastric resection, all 45 patients were disease free at a median follow-up of 74 months (range, 1–181).


      Although technically demanding, tailored laparoscopic resection based on tumor characteristics in most patients with suspected gastric GIST is safe and feasible and resultis in good both surgical and oncologic outcomes.
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