This Article Full Text (PDF) References Alert me when this article is cited Alert me if a correction is posted Services Email this article to a friend Similar articles in this journal Similar articles in Web of Science Similar articles in PubMed Alert me to new issues of the journal Add to Saved Citations Download to citation manager Request Permissions Request Reprints Add to My Marked Citations Citing Articles Citing Articles via HighWire Citing Articles via Web of Science (3) Citing Articles via Google Scholar Citing Articles via Scopus Google Scholar Articles by Berindoague, R. Articles by Trias, M. Search for Related Content PubMed PubMed Citation Articles by Berindoague, R. Articles by Trias, M. Pubmed/NCBI databases Medline Plus Health Information Endoscopy Stomach Cancer Social Bookmarking                         What's this?

Laparoscopic Resection of Clinically Suspected Gastric Stromal Tumors

Service of General and Digestive Surgery, Hospital de Sant Pau, Autonomous University of Barcelona, Barcelona, Spain

Eduard Mª Targarona, MD, PhD

Service of Surgery, Hospital de Sant Pau, C/ Padre Claret 167. 08025, Barcelona, Spain; Etargarona{at}hsp.santpau.es

Xavier Feliu, MD

Vicenç Artigas, MD, PhD

Carmen Balagué, MD, PhD

Service of General and Digestive Surgery, Hospital de Sant Pau, Autonomous University of Barcelona, Barcelona, Spain

Aurora Aldeano, MD, PhD

Antonio Lahoud, MD

Jordi Navines, MD

Service of General and Digestive Surgery, Hospital de Sant Pau, Autonomous University of Barcelona, Barcelona, Spain

Enrique Fernandez-Sallent, MD, PhD

Service of Surgery, Hospital General d'Igualada, Igualada, Spain

Manuel Trias, MD, PhD

Service of General and Digestive Surgery, Hospital de Sant Pau, Autonomous University of Barcelona, Barcelona, Spain

Gastrointestinal stromal tumors (GISTs) account for 5% of all gastric tumors. Preoperative diagnosis is relatively difficult because biopsy samples are rarely obtained during fibergastroscopy. Surgical radical resection is the gold standard treatment, allowing pathologic study for both diagnosis and prognosis. Laparoscopic resection has become an alternative to the open approach, but long-term results are not well known. The aim of this study is to report experience with laparoscopic resection, placing special emphasis on preoperative diagnosis and describing long-term results. A retrospective analysis was made of all patients undergoing a laparoscopic resection for clinically suspected gastrointestinal stromal tumors between November 1998 and August 2006 at 2 tertiary hospitals. The medical records of all participants were reviewed regarding surgical technique, clinicopathologic features, and postoperative long-term outcome. Laparoscopic gastric resection was attempted in 22 patients (13 women and 9 men) with a mean age of 66.7 years (range, 29-84 years). One patient had 2 gastric tumors. Tumor localization was upper gastric third in 6 patients, mid-gastric third in 7, and distal third in 10. Surgical techniques were transgastric submucosal excision (n = 1), wedge resection (n = 13), partial gastrectomy with Y-en-Roux reconstruction (n = 6), and total gastrectomy with Y-en-Roux reconstruction (n = 2). Two patients (9.1%) required conversion to the open procedure because of tumor size. Postoperative morbidity was delayed gastric emptying in 3 patients. Median postoperative stay was 6 days (range, 4-32 days). Pathologic and immunohistochemical study confirmed gastrointestinal stromal tumors in 18 cases. The other 4 cases were adenomyoma, hamartoma, plasmocytoma, and parasitic tumor (anisakis). Median tumor size was 5.6 cm (range, 2.5-12.5 cm) in cases of gastrointestinal stromal tumors. Malignant risk of gastrointestinal stromal tumors assessed according to mitotic index and size was low (n = 8), intermediate (n = 6), or high (n = 4). After a median follow-up of 32 months (range, 1-72 months), there was 1 case of recurrence of GIST. Definitive preoperative diagnosis of gastric submucosal tumors is frequently difficult. The laparoscopic approach to surgical treatment of these tumors seems safe and is associated with acceptable intermediate-term results, especially in cases of gastrointestinal stromal tumors.

Key Words: Gastrointestinal stromal tumor • Laparoscopic resection • Laparoscopic gastrectomy

Surgical Innovation, Vol. 13, No. 4, 231-237 (2006)
DOI: 10.1177/1553350606295960


CiteULike    Complore    Connotea    Del.icio.us    Digg    Reddit    Technorati    Twitter    What's this?

This article has been cited by other articles:

				M. Zerey and B. T. Heniford Gastrointestinal Stromal Tumors Surgical Innovation, March 1, 2007; 14(1): 67 - 68. [PDF]