Skip to main content
Key Specialties
Cardiology Diabetology Endocrinology Gastroenterology Geriatrics and Gerontology Gynecology and Obstetrics Hematology Infectious Disease Internal Medicine Nephrology Neurology Oncology Pediatrics Respiratory Medicine Rheumatology Surgery
Congress Coverage
2024 ACC Congress 2023 ESMO Congress 2023 EASD Congress 2023 ERS Congress 2023 ESC Congress 2023 EHA Congress 2023 ASCO Annual Meeting
Clinical Collections
Advances in Alzheimer’s

At a glance: The ONWARDS insulin icodec trials

A round-up of the ONWARDS phase 3 clinical trials evaluating the novel weekly insulin icodec in people with diabetes.
ADVANCED SEARCH
Log in
Top
Surgical Endoscopy
Published in: Surgical Endoscopy 10/2007

01-10-2007 | Review

Gastrointestinal stromal tumors (GIST) and laparoscopic resection

Authors: Sanjoy Basu, Sam Balaji, David H. Bennett, Nick Davies

Published in: Surgical Endoscopy | Issue 10/2007

Login to get access

Abstract

Aim

To review management, outcome and the lessons learnt from a laparoscopic approach to GISTs.

Method

All cases of GIST presenting to the upper GI MDT between 2000 and 2006 were reviewed. Presentation, preoperative investigations, management and follow-up were recorded. Surgical resection using a laparoscopic approach, where feasible was the preferred management.

Results

25 consecutive patients that included one oesophageal, three oesophago-gastric, 19 gastric and two smallbowel GISTs were treated between 2000 and 2006. There were 11 male and 14 females with a median age of 68 (25–90) years. Clinical presentation was: gastrointestinal bleed 15, pain 6, dysphagia 2, anaemia 3, weight loss 1, and asymptomatic 2. Out of 25, four were inoperable and treated with imatinib. 17 laparoscopic (including 2 conversions) and four open procedures were performed. Two (both GISTs close to the oesophago-gastric junction) required reoperation due to surgical-related morbidity. Of the 25, five were high-, 11 intermediate- and nine low-risk GISTs. No recurrences in follow-up (median 24, range 6–75) months was observed.

Conclusion

GISTs can safely and effectively be treated laparoscopically although larger GISTs in difficult anatomical locations may require open surgery.
Literature
1.
Rossi CR, Mocellin S, Mancarelli R, Foletto M, Pilati P, Nitti D (2003) Gastrointestinal stromal tumours: from a surgical to a molecular approach. Int J Cancer 107:171–176PubMedCrossRef
2.
Kindblom LG (2003) Education Session E450, oral presentation “Gastrointestinal Stromal Tumours Diagnosis, Epidemiology and Prognosis” in Gastrointestinal Stromal Tumour: Current management and Future Challenges. Chair: Blanke CD. ASCO
3.
Corless CL, Fletcher JA, Heinrich MC (2004) Biology of gastrointestinal stromal tumours. J Clin Oncol 22:3813–3825PubMedCrossRef
4.
Mazur MT, Clark HB (1983) Gastric stromal tumours. Reappraisal of histogenesis. Am J Surg Pathol 7:507–519PubMedCrossRef
5.
Kindblom LG, Remotti HE, Aldenborg F, Meis-Kindblom JM (1998) Gastrointestinal stromal tumours show phenotypic characteristics of the interstitial cells of Cajal. Am J Pathol 152:1259–1269PubMed
6.
DeMatteo RP, Lewis JJ, Leung D, Jeung D, Mudan SS, Woodruff JM, Brennan MF (2000) Two hundred gastrointestinal stromal tumour: recurrence patterns and prognostic factors for survival. Ann Surg 231:51–58PubMedCrossRef
7.
Nowain A, Bhakta H, Pais S, Kanel G, Verma S (2005) Gastrointestinal stromal tumours: clinical profile, pathogenesis, treatment strategies and prognosis. J Gastroenterol Hepatol 20(6):818–824PubMedCrossRef
8.
Miettinen M, Virolainen M, Maarit Sarlomo R (2005) Gastrointestinal stromal tumour of the stomach: a clinicopathologic, immunohistochemical and molecular genetic study of 1765 cases with long-term follow-up. Am J Surg Pathol 29:52–68PubMedCrossRef
9.
Heinrich MC, Corless CL (2005) Gastric GI stromal tumours (GISTs): the role of surgery in the era of targeted therapy. J Surg Oncol 90:195–207PubMedCrossRef
10.
Cheng HL, Lee WJ, Lai IR, Yuan RH, Yu SC (1999) Laparoscopic wedge resection of benign gastric tumour. Hepatogastroenterology 46:2100–2104PubMed
11.
Neuhaus SJ, Clark MA, Hayes AJ, Thomas JM, Judson I (2005) Surgery for gastrointestinal stromal tumour in the post-imatinib era. ANZ J Surg 75:165–172PubMedCrossRef
12.
Roberts PJ, Eisenberg B (2002) Clinical presentation of gastrointestinal stromal tumours and treatment of operable disease. Eur J Cancer 38:S37–38PubMedCrossRef
13.
Mathews BD, Walsh RM, Kercher KW, Sing RF, Pratt BL, Answini GA, Heniford BT (2002) Laparoscopic vs open resection of gastric stromal tumours. Surg Endosc 16:803–807CrossRef
14.
15.
Novitsky YW, Kercher KW, Sing RF, Heniford BT (2006) Long-term outcome of laparoscopic resection of gastric gastrointestinal stromal tumours. Ann Surg 243(6):738–747PubMedCrossRef
16.
Heniford BT, Arca MJ, Walsh RM (2000) The mini-laparoscopic intragastric resection of a gastroesophageal stromal tumour: a novel approach. Surg Laparosc Percutan Tech 10:82–85CrossRef
17.
Walsh RM, Ponsky J, Brody F, Mathews BD, Heniford BT (2003) Combined endoscopic/laparoscopic intragastric resection of gastric stromal tumours. J Gastrointest Surg 7:386–392PubMedCrossRef
18.
Geis WP, Baxt R, Kim HC (1996) Benign gastric Tumours: minimally invasive approach. Surg Endosc 10:407–410PubMedCrossRef
19.
Nguyen NT, Jim J, Nguyen A, Lee J, Chang K (2003) Laparoscopic resection of gastric stromal tumour: a tailored approach. Am Surg 69:946–950PubMed
20.
Fletcher CD, Bermenn JJ, Corless C, Gorstein F, Lasota J, Longley BJ, Miettinen M, O’Leary TJ, Renotti H, Rubin BP, Shmokler B, Solin LH, Weiss SW (2002) Diagnosis of gastrointestinal stromal tumours: a consensus approach. Hum Pathol 33:459–465PubMedCrossRef
21.
DeMatteo RP, Heinrich MC, El-Rifai WM, Demetri G (2002) Clinical management of gastrointestinal stromal tumours: before and after STI-571. Hum Pathol 33:466–477PubMedCrossRef
22.
Rosen MJ, Heniford BT (2005) Endoluminal gastric surgery: the modern era of minimally invasive surgery. Surg Clin North Am 85:989–1007PubMedCrossRef
23.
Yoshida M, Otani Y, Ohgami M, Kubota T, Kumai K, Mukai M, Kitajima M (1997) Surgical management of gastric leimyosarcoma: evaluation of the propriety of laparoscopic wedge resection. World J Surg 21:440–443PubMedCrossRef
24.
Ludwig K, Wilhelm L, Scharlau U, Amtsberg G, Bernhardt J (2001) Laparoscopic-endoscopic rendezvous resection of gastric tumours. Surg Endosc 16:1561–1565CrossRef
25.
Tagaya N, Mikami H, Kogure H, Kubota K, Hosoya Y, Nagai H (2002) Laparoscopic intragastric stapled resection of gastric submucosal tumours located near the esophgaogastric junction. Surg Endosc 16:177–179PubMedCrossRef
26.
Rothlin M, Schob O (2001) Laparoscopic wedge resection for benign gastric tumour. Surg Endosc 15:893–895PubMedCrossRef
27.
Granger SR, Rollins MD, Mulvihill SJ, Glasgow RE (2006) Lessons learned from laparoscopic treatment of gastric and gastroesophageal junction stromal tumours. Surg Endosc 20:1299–1304PubMedCrossRef
28.
Ng EH, Pollock RE, Munsell ME, Atkinson EN, Romsdahl MM (1992) Prognostic factors influencing survival in gastrointestinal leiomyosarcomas. Ann Surg 215:68–77PubMedCrossRef
29.
Fujimoto Y, Nakanishi Y, Yoshimura K, Shimoda T (2003) Clinicopathologic study of primary malignant gastrointestinal stromal tumour of the stomach, with special reference to prognostic factors: analysis of results in 140 surgically resected patients. Gastric Cancer 6:39–48PubMedCrossRef
30.
Demetri GD, Blanke CD (2004) NCCN Task Force Report. Optimal management of patients with gastrointestinal stromal tumours (GIST): expansion and update of NCCN Clinical Guidelines. J Natl Comp Cancer Network 2(suppl):1–26
31.
Miettinen M, El-Rifal W, Sobin LH, Lasota J (2002) Evaluation of malignancy and prognosis of gastrointestinal stromal tumours: A review. Hum Pathol 33:478–483PubMedCrossRef
32.
Yan H, Marchettini P, Acherman YI, Gething SA, Brun E, Sugarbaker PH (2003) Prognostic assessment of gastrointestinal stromal tumour. Am J Clin Oncol 26:221–228PubMedCrossRef
33.
Eisenberg BL, Judson I (2004) Surgery and imatinib in the management of GIST: emerging approaches to adjuvant and Neoadjuvant therapy. Ann Surg Oncol 11(5):465–475PubMedCrossRef
34.
Reichardt P (2003) Practical aspects of managing gastrointestinal stromal tumours. Monographs in Gastrointestinal Stromal Tumours 1:3–8
35.
Blanke CD, Eisenberg BL, Heinrich MC (2001) Gastrointestinal stromal tumours. Curr Treat Options Oncol 2:485–491PubMedCrossRef
36.
Buemming P, Meis-Kindblom JM, Kindblom LG, Gustavsson B, Thakrar B, Engstrom K, Ahlman H, Nilsson BE (2003) Is there an indication for adjuvant treatment with imatinib mesylate in patients with aggressive gastrointestinal stromal tumours (GISTs)? Proc Am Soc Clin Oncol 22:818
Metadata
Title
Gastrointestinal stromal tumors (GIST) and laparoscopic resection
Authors
Sanjoy Basu
Sam Balaji
David H. Bennett
Nick Davies
Publication date
01-10-2007
Publisher
Springer-Verlag
Published in
Surgical Endoscopy / Issue 10/2007
Print ISSN: 0930-2794
Electronic ISSN: 1432-2218
DOI
https://doi.org/10.1007/s00464-007-9445-z

Other articles of this Issue 10/2007

Surgical Endoscopy 10/2007 Go to the issue

OriginalPaper

Do manual assisting maneuvers increase speed and technical performance in robotically sutured coronary bypass graft anastomoses?

OriginalPaper

The Impact of Uncomplicated and Complicated Diverticulitis on Laparoscopic Surgery Conversion Rates and Patient Outcomes

OriginalPaper

A newly designed ergonomic body support for surgeons

OriginalPaper

Colonoscopy in the very elderly: a review of 157 cases

Letter to the Editor

Scarless endoscopic surgery: NOTES or TUES

OriginalPaper

Robot-assisted versus conventional laparoscopic fundoplication: short-term outcome of a pilot randomized controlled trial