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Erschienen in: Surgical Endoscopy 10/2014

01.10.2014

Laparoscopic resection of large gastric GISTs: feasibility and long-term results

verfasst von: Luigi Masoni, Ivan Gentili, Riccardo Maglio, Massimo Meucci, Giancarlo D’Ambra, Emilio Di Giulio, Giovanni Di Nardo, Vito Domenico Corleto

Erschienen in: Surgical Endoscopy | Ausgabe 10/2014

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Abstract

Background

Laparoscopy is the procedure of choice for the resection of gastric Gastrointestinal stromal tumors (GISTs) smaller than 2 cm; there is still debate regarding the most appropriate operative approach for larger GISTs. The aims of this study were to evaluate the safety and long-term efficacy of laparoscopic resection of gastric GISTs larger than 2 cm.

Methods

Between 2007 and 2011, we prospectively enrolled all patients affected by gastric GIST larger than 2 cm. Exclusion criteria for the laparoscopic approach were the presence of metastases and the absence of any involvement of the esophago-gastric junction, the pyloric canal, or any adjacent organ. Final diagnosis of GIST was confirmed by histological and immunohistochemical analysis. Follow-up assessment included abdominal CT scans every 6 months for the first 2 years and yearly thereafter.

Results

Twenty-four consecutive patients were enrolled. Twenty-one patients (87.5 %) were symptomatic. The most common symptoms were gastrointestinal bleeding and abdominal pain. The mean tumor size was 5.51 cm (range 2.5–12.0 cm). GISTs were located in the lesser curvature in five cases (20.8 %), in the greater curvature in seven cases (29.1 %), in the posterior wall in one case (4.1 %), in the anterior wall in eight cases (33.3 %), and in the fundus in 3 cases (12.5 %). Laparoscopic resection was possible in all cases and took on average of 55 min (range 30–105 min). Median blood loss was 24 ml. No major intraoperative complications were observed. Mortality rate was 0 %. Median postoperative stay was 3 days. No patients were lost to follow-up. No recurrences occurred after a median follow-up period of 75 months.

Conclusion

Although larger randomized controlled trials comparing different surgical strategies for large gastric GISTs are warranted, our study supports the evidence that laparoscopic resection of gastric GISTs is feasible, safe, and effective on long-term clinical outcome even for lesions up to 12 cm.
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Metadaten
Titel
Laparoscopic resection of large gastric GISTs: feasibility and long-term results
verfasst von
Luigi Masoni
Ivan Gentili
Riccardo Maglio
Massimo Meucci
Giancarlo D’Ambra
Emilio Di Giulio
Giovanni Di Nardo
Vito Domenico Corleto
Publikationsdatum
01.10.2014
Verlag
Springer US
Erschienen in
Surgical Endoscopy / Ausgabe 10/2014
Print ISSN: 0930-2794
Elektronische ISSN: 1432-2218
DOI
https://doi.org/10.1007/s00464-014-3552-4

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