Laparoscopic wedge resection for gastric GIST: Long-term follow-up results☆

Abstract 

Aim

Gastrointestinal stromal tumor (GIST) is the most common mesenchymal neoplasm of the gastrointestinal tract. Recently, many investigations have been conducted on various aspects of laparoscopic surgery for gastric GIST. However, no study has provided long-term follow up results of laparoscopic surgery for gastric GIST. The aims of this study were to assess the feasibility and safety of laparoscopic surgery for gastric GIST and to evaluate the oncologic validity of the procedure.

Materials and methods

Between January 1998 and August 2005, 51 patients with submucosal tumor of the stomach were treated by laparoscopic surgery at our institution. Of 51 patients, 23 patients were confirmed as gastric GIST by immunohistochemistry (CD 117, c-kit gene product). Patients' clinicopathologic characteristics, operative outcomes, postoperative complications, and follow-up findings were analyzed retrospectively.

Results

The mean age of patients was 59.7years, and 12 patients were women. Twelve patients (47%) presented with epigastric pain. The mean tumor size was 4.2±2.1cm, and most tumors were located in the upper stomach (52.2%). The mean operative time was 104.3min. No case of open conversion, reoperation and operative mortality occurred in the present study. Most patients had very low and low risk (60.6%), while only two patients had high risk malignancy. During a median follow-up period of 61months (range, 7–98months), there have been no recurrences or metastases.

Conclusion

Laparoscopic wedge resection for gastric GIST is safe, and oncologically and technically feasible in the hands of an experienced laparoscopic gastric surgeon.

Keywords: Gastrointestinal stromal tumor, Stomach, Laparoscopic surgery