DOI QR코드

DOI QR Code

Totally Laparoscopic Resection for a Large Gastrointestinal Stromal Tumor of Stomach

  • Lee, Jeong-Sun (Department of Surgery, Incheon St. Mary's Hospital, The Catholic University of Korea) ;
  • Kim, Jin-Jo (Department of Surgery, Incheon St. Mary's Hospital, The Catholic University of Korea) ;
  • Park, Seung-Man (Department of Surgery, Incheon St. Mary's Hospital, The Catholic University of Korea)
  • Received : 2011.12.02
  • Accepted : 2011.12.15
  • Published : 2011.12.30

Abstract

A debate is currently ongoing about whether a large gastrointestinal stromal tumor (GIST) should be treated by the laparoscopic approach because of the increased risk of tumor rupture during manipulation of the tumor with laparoscopic instruments and the resultant peritoneal tumor dissemination. Herein, we report a case of a large GIST of the stomach which was successfully treated by the laparoscopic approach. A 57 year old female patient visited our institution complaining of postprandial epigastric discomfort. An esophagogastroduodenoscopy and an abdominal computed tomography scan revealed a $10{\times}8$ cm sized submucosal tumor at the greater curvature side of the gastric antrum. The patient underwent laparoscopic distal gastrectomy with intracorporeal Billroth-II reconstruction without any breakage of the tumor. Her postoperative course was uneventful and she was discharged on the 7th postoperative day. Even a large GIST of the stomach can safely be treated by the laparoscopic approach when it is performed with proper techniques by an experienced surgeon.

Keywords

References

  1. Basu S, Balaji S, Bennett DH, Davies N. Gastrointestinal stromal tumors (GIST) and laparoscopic resection. Surg Endosc 2007;21:1685-1689. https://doi.org/10.1007/s00464-007-9445-z
  2. Gervaz P, Huber O, Morel P. Surgical management of gastrointestinal stromal tumours. Br J Surg 2009;96:567-578. https://doi.org/10.1002/bjs.6601
  3. Melstrom LG, Phillips JD, Bentrem DJ, Wayne JD. Laparoscopic versus open resection of gastric gastrointestinal stromal tumors. Am J Clin Oncol 2011. [Epub ahead of print]
  4. Ke CW, Cai JL, Chen DL, Zheng CZ. Extraluminal laparoscopic wedge resection of gastric submucosal tumors: a retrospective review of 84 cases. Surg Endosc 2010;24:1962-1968. https://doi.org/10.1007/s00464-010-0888-2
  5. Goh BK, Chow PK, Chok AY, Chan WH, Chung YF, Ong HS, et al. Impact of the introduction of laparoscopic wedge resection as a surgical option for suspected small/medium-sized gastrointestinal stromal tumors of the stomach on perioperative and oncologic outcomes. World J Surg 2010;34:1847-1852. https://doi.org/10.1007/s00268-010-0590-5
  6. Catena F, Di Battista M, Fusaroli P, Ansaloni L, Di Scioscio V, Santini D, et al. Laparoscopic treatment of gastric GIST: report of 21 cases and literature's review. J Gastrointest Surg 2008;12:561-568. https://doi.org/10.1007/s11605-007-0416-4
  7. Novitsky YW, Kercher KW, Sing RF, Heniford BT. Long-term outcomes of laparoscopic resection of gastric gastrointestinal stromal tumors. Ann Surg 2006;243:738-745. https://doi.org/10.1097/01.sla.0000219739.11758.27
  8. Ishikawa K, Inomata M, Etoh T, Shiromizu A, Shiraishi N, Arita T, et al. Long-term outcome of laparoscopic wedge resection for gastric submucosal tumor compared with open wedge resection. Surg Laparosc Endosc Percutan Tech 2006;16:82-85. https://doi.org/10.1097/00129689-200604000-00005
  9. Demetri GD, Benjamin RS, Blanke CD, Blay JY, Casali P, Choi H, et al; NCCN Task Force. NCCN Task Force report: management of patients with gastrointestinal stromal tumor (GIST)--update of the NCCN clinical practice guidelines. J Natl Compr Canc Netw 2007;5 Suppl 2:S1-29.

Cited by

  1. Surgical Treatment of Gastric Gastrointestinal Stromal Tumor vol.13, pp.1, 2013, https://doi.org/10.5230/jgc.2013.13.1.3
  2. Combined laparoscopic and endoscopic excision of a gastric gist vol.27, pp.9, 2011, https://doi.org/10.1007/s00464-013-2983-7
  3. Minimally invasive surgery for submucosal (subepithelial) tumors of the stomach vol.20, pp.36, 2014, https://doi.org/10.3748/wjg.v20.i36.13035
  4. Surgical Management of Gastrointestinal Stromal Tumors of the Stomach vol.18, pp.1, 2014, https://doi.org/10.4293/108680813x13693422522150
  5. Laparoscopic versus open gastric resection for larger than 5 cm primary gastric gastrointestinal stromal tumors (GIST): a size-matched comparison vol.28, pp.9, 2011, https://doi.org/10.1007/s00464-014-3506-x
  6. Laparoscopic versus open wedge resection for gastrointestinal stromal tumors of the stomach: a single-center 8-year retrospective cohort study of 156 patients with long-term follow-up vol.15, pp.None, 2015, https://doi.org/10.1186/s12893-015-0040-2
  7. Laparoscopic Surgery for Large Gastric Submucosal Tumors vol.27, pp.6, 2011, https://doi.org/10.1097/sle.0000000000000479