Minimally invasive surgery for posterior gastric stromal tumors.
BACKGROUND
Because involvement is extremely rare, surgery for gastric stromal tumors consists of local excision with clear resection margins. The aim of this study was to report the results of a consecutive series of nine patients with posterior gastric stromal tumors that were excised using a minimally invasive method.


METHODS
Patients received a general anesthetic before placement of three laparoscopic ports- a 10-mm (umbilical) port for the telescope and two working ports, a 12-mm port (left upper quadrant) and a 10-mm port (right upper quadrant). Grasping forceps were placed through an anteriorly placed gastrotomy to deliver the tumor through the gastrotomy into the abdominal cavity, thus allowing an endoscopic linear cutter to excise the tumor with a cuff of normal gastric tissue.


RESULTS
Nine consecutive patients with a median age of 73 years (range, 47-83) were treated. In seven patients, laparoscopic removal of the tumor was achieved. Two patients required conversion to an open operation because the tumor could not be delivered into the abdominal cavity. The median length of postoperative stay for the seven patients in whom the procedure was completed laparoscopically was 3 days (range, 2-6).


CONCLUSIONS
Posterior gastric stromal tumors can be removed safely using this minimally invasive method. Delivery of the tumor through the gastrotomy is essential for success.
Hepworth
C C
CC
Colchester General Hospital, Turner Road, Colchester, Essex CO4 5JL, UK.
Menzies
D
D
Motson
R W
RW
D000368:Aged; D000369:Aged, 80 and over; D004564:Electrocoagulation; D005743:Gastrectomy / Q000379:methods*; D005773:Gastroscopy; D006801:Humans; D010535:Laparoscopy; D018230:Leiomyoma, Epithelioid / Q000473:pathology / Q000601:surgery*; D007890:Leiomyosarcoma / Q000473:pathology / Q000601:surgery*; D007902:Length of Stay; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local; D013274:Stomach Neoplasms / Q000473:pathology / Q000601:surgery*; D016896:Treatment Outcome