Surgical Management and Technique of Gastric Gastrointestinal Stromal Tumors Based on Location

Ellyn Smith, MD

Product Details
Product ID: ACS-6061
Year Produced: 2020
Length: 7 min.


Introduction: Gastrointestinal stromal tumors (GISTs) are the most common nonepithelial neoplasms involving the gastrointestinal tract. [1] Within the gastrointestinal tract, GISTs are most common in the stomach (40-60%). [2] The management of the GISTs depends upon the tumor location and size. We describe multiple techniques for removal of GISTs based on the location within the stomach. Methods: For tumors along the greater curvature of the stomach we demonstrate a laparoscopic wedge resection, with mobilization of the greater curvature. A trans-gastric excision, with placement of laparoscopic ports into the stomach is utilized for a mass that is located at the gastroesophageal junction (GEJ) near the fundus. And lastly, a third technique is to utilize enucleation when the tumor is located is at the GEJ. Results: All procedures were completed laparoscopically. There were no intraoperative complications, or conversions to open procedures. Patients were placed on a liquid diet on post operative day (POD) zero. Contrast imaging was completed on POD#1 without evidence of leak. Conclusion: Laparoscopic techniques are a feasible and safe option for the removal of GISTs. Laparoscopic surgeons should be familiar with the variety of techniques utilized in resection of gastric GISTs based on the location of the tumor. References: 1. Miettinen M, Lasota J. Gastrointestinal stromal tumors--definition, clinical, histological, immunohistochemical, and molecular genetic features and differential diagnosis. Virchows Arch 2001; 438:1. 2. Tran T, Davila JA, El-Sera HB. The epidemiology of malignant gastrointestinal stromal tumors: an analysis of 1,458 cases from 1992 to 2000. Am J Gastroenterol 2005; 100:162.