Gastrointestinal stromal tumors (GIST) and laparoscopic resection.
OBJECTIVE
To review management, outcome and the lessons learnt from a laparoscopic approach to GISTs.


METHODS
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.


CONCLUSIONS
GISTs can safely and effectively be treated laparoscopically although larger GISTs in difficult anatomical locations may require open surgery.
Upper Gastrointestinal Unit, Royal Bournemouth Hospital, Castle Lane East, Bournemouth, BH7 7DW, United Kingdom. sanjoy000@tiscali.co.uk
Sanjoy
S
Basu
Sam
S
Balaji
David H
DH
Bennett
Nick
N
Davies
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D046152:Gastrointestinal Stromal Tumors / Q000473:pathology / Q000601:surgery*; D006801:Humans; D010535:Laparoscopy; D008297:Male; D008875:Middle Aged