Background
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.
Methods
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.
Results
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).
Conclusion
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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Article info
Publication history
Published online: December 11, 2009
Accepted:
October 6,
2009
Identification
Copyright
© 2010 Mosby, Inc. Published by Elsevier Inc. All rights reserved.
