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.
Basu
Sanjoy
S
Upper Gastrointestinal Unit, Royal Bournemouth Hospital, Castle Lane East, Bournemouth, BH7 7DW, United Kingdom. sanjoy000@tiscali.co.uk
Balaji
Sam
S
Bennett
David H
DH
Davies
Nick
N
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