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Erschienen in:
01.10.2007 | Review
Gastrointestinal stromal tumors (GIST) and laparoscopic resection
Erschienen in: Surgical Endoscopy | Ausgabe 10/2007
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Aim
To review management, outcome and the lessons learnt from a laparoscopic approach to GISTs.
Method
All cases of GIST presenting to the upper GI MDT between 2000 and 2006 were reviewed. Presentation, preoperative investigations, management and follow-up were recorded. Surgical resection using a laparoscopic approach, where feasible was the preferred management.
Results
25 consecutive patients that included one oesophageal, three oesophago-gastric, 19 gastric and two smallbowel GISTs were treated between 2000 and 2006. There were 11 male and 14 females with a median age of 68 (25–90) years. Clinical presentation was: gastrointestinal bleed 15, pain 6, dysphagia 2, anaemia 3, weight loss 1, and asymptomatic 2. Out of 25, four were inoperable and treated with imatinib. 17 laparoscopic (including 2 conversions) and four open procedures were performed. Two (both GISTs close to the oesophago-gastric junction) required reoperation due to surgical-related morbidity. Of the 25, five were high-, 11 intermediate- and nine low-risk GISTs. No recurrences in follow-up (median 24, range 6–75) months was observed.
Conclusion
GISTs can safely and effectively be treated laparoscopically although larger GISTs in difficult anatomical locations may require open surgery.