title: Laparoscopic gastric resection approaches for gastrointestinal stromal tumors of stomach.
abstract: OBJECTIVE
  To evaluate laparoscopic gastric resection for gastrointestinal stromal tumors (GIST).
  
  
  METHODS
  From June, 2003 to October, 2009, 56 patients with gastric GIST who underwent laparoscopic gastric resection were retrospectively reviewed, and their surgical procedure, perioperative outcomes, pathology, and follow-up outcomes were analyzed.
  
  
  RESULTS
  All patients underwent laparoscopic gastric resection successfully, including 33 laparoscopic wedge resections, 19 laparoscopic transgastric tumor-everting resections, 3 laparoscopic-assisted distal gastrectomies, and 1 laparoscopic-assisted endoscopic resection. The operative approaches performed were mostly based on the tumor location. No conversions were observed. The mean operative duration was 90 minutes (30 to 210 min), blood loss was 55 mL (5 to 180 mL), time for passage of flatus was 2 days (1 to 11 d), and the postoperative hospital stay was 7 days (3 to 13 d). The resection margin was microscopic negative. After 21.5 months (6 to 76 mo) of follow-up, there was no operative recurrence and metastasis.
  
  
  CONCLUSIONS
  Laparoscopic gastric resection for selective cases of gastric GISTs is safe, feasible, and effective. Laparoscopic wedge resection procedure is the first choice for most GISTs located in fundus and anterior wall, laparoscopic transgastric tumor-everting resection procedure can be used in cases with the tumor located in esophagogastric junction area and in posterior wall of the stomach as well. For antral tumors, laparoscopic subtotal gastrectomy with gastrojejunostomy should be performed.
authors.affiliation: Department of General Surgery, Shanghai Minimally Invasive Surgery Center, Rui-Jin Hospital, Shanghai Jiao-Tong University School of Medicine, Shanghai, China.
authors.forename: Jun-jun
authors.initials: JJ
authors.lastname: Ma
authors.forename: Wei-guo
authors.initials: WG
authors.lastname: Hu
authors.forename: Lu
authors.initials: L
authors.lastname: Zang
authors.forename: Xiao-wei
authors.initials: XW
authors.lastname: Yan
authors.forename: Ai-guo
authors.initials: AG
authors.lastname: Lu
authors.forename: Ming-liang
authors.initials: ML
authors.lastname: Wang
authors.forename: Jian-wen
authors.initials: JW
authors.lastname: Li
authors.forename: Bo
authors.initials: B
authors.lastname: Feng
authors.forename: Jie
authors.initials: J
authors.lastname: Zhong
authors.forename: Min-hua
authors.initials: MH
authors.lastname: Zheng
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D018952:Antigens, CD34; D002681:China; D005260:Female; D046152:Gastrointestinal Stromal Tumors / Q000473:pathology / Q000601:surgery*; D006801:Humans; D010535:Laparoscopy / Q000379:methods / Q000706:statistics & numerical data*; D008297:Male; D008875:Middle Aged; D010149:Postoperative Pain; D011379:Prognosis; D012189:Retrospective Studies; D012307:Risk Factors; D013274:Stomach Neoplasms / Q000473:pathology / Q000601:surgery*; D013997:Time Factors; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D018952:Antigens, CD34