Laparoscopic Treatment of Gastric Gist: Report of 21 Cases and Literature’s Review

Abstract

As found also in the literature review, the laparoscopic resection is safe and effective in treating gastric GISTs. Given these findings as well as the advantages afforded by laparoscopic surgery, a minimally invasive approach should be the preferred surgical treatment in patients with small- and medium-sized gastric GISTs.

Experience with Open and Laparoscopic Surgery for Primary Gastric Stromal Tumors in a Single Institute

“…[8] In our study, wedge resection was the most frequently performed procedure in both the open and laparoscopic groups (78.8% and 91.3% respectively).…”

“…[8] [15] Sokolich et al [4] reported that minimally invasive surgery should not be precluded in a large tumor size of GISTs, even 20 cm in size. There are increasing literature reports on the safety and feasibility of laparoscopic surgery for the treatment of stomach GISTs.…”

Treatment Options for Gastrointestinal Stromal Tumors

“…These surgical approaches have been reported to be associated with significantly fewer complications, reduced pain, faster recovery, and improved cosmesis compared with traditional open or laparoscopic approaches. It is likely that these newly developed minimally invasive surgery will be applied to miscellaneous surgical diseases, including GIST, in the near future (Catena et al, 2008;Choi et al, 2007;Horgan et al, 2011;Karakousis et al, 2011;Kingham & DeMatteo, 2009;Novitsky et al, 2006;Otani et al, 2006;Privette et al, 2008;Sasaki et al, 2010;Sexton et al, 2008Woodall et al, 2009). …”

Surgical Treatment of Gastrointestinal Stromal Tumors (GISTs)

“…Several authors proposed the adoption of widened indications for the laparoscopic surgery in GISTs (Mochizuki, Kodera et al 2004;Mochizuki, Kodera et al 2006). Several studies described the accomplishment of laparoscopic resection of tumors with dimensions between 0.3 and 12.5 cm (Catena, Di Battista et al 2008;Hohenberger and Eisenberg 2010), supplying evidence for the application of this procedure mainly in gastric GISTs. However, there are no controlled randomized studies in prospective clinical trials concluded to date to validate these options.…”

“…However, there are no controlled randomized studies in prospective clinical trials concluded to date to validate these options. In the NCCN 2007 update, it is considered acceptable the laparoscopic resection of tumors > 5 cm, depending on the localization and the morphology, using laparoscopic or handassisted techniques (Novitsky, Kercher et al 2006;Demetri, Benjamin et al 2007;Catena, Di Battista et al 2008;Demetri, von Mehren et al 2010). Before initiating the resection of the tumor, a formal throughout exploration of the abdominal cavity must be carried out to exclude the eventual presence of peritoneal or liver metastases.…”