title: Laparoscopic resection for gastrointestinal stromal tumors in the stomach.
abstract: OBJECTIVE
  Gastrointestinal stromal tumors (GISTs) should be surgically resected, even those smaller than 5 cm in size, which is the threshold of clinical malignancy for submucosal tumors (SMTs) in the gastrointestinal tract. This study reviewed the use of laparoscopic surgery for gastric partial resection of GISTs or SMTs that were suspected to be GISTs.
  
  
  METHODS
  Eighteen patients underwent laparoscopic partial resection of the stomach for GISTs or SMTs. The tumor location was confirmed by intraluminal endoscopy. One-half of the circumference around the tumor was dissected, and the tumor was turned toward the abdominal cavity. The nonresected part of the tumor and the edge of the incision line was lifted up using forceps, and the incision line was closed using laparoscopic stapling devices.
  
  
  RESULTS
  Two cases were diagnosed as GIST by endoscopic biopsy. Six patients underwent endoscopic ultrasound-guided fine-needle aspiration biopsy (EUS-FNAB) examinations, which diagnosed five GISTs. There were 18 tumors smaller than 5 cm, including 10 GISTs, 4 leiomyomas, 3 schwannomas, and one heterotopic pancreas.
  
  
  CONCLUSIONS
  Endoscopic ultrasound-guided FNAB is recommended for definite preoperative diagnosis of histopathologically unknown SMTs to determine the indications for surgery. The laparoscopic approach with the assistance of endoscopy is useful for improving the curability, with minimal invasiveness for the partial resection of GISTs.
authors: Department of Surgery and Science, Graduate School of Medical Sciences, Kyushu University, 3-1-1 Maidashi, Higashi-ku, Fukuoka, Japan. kakeji@surg2.med.kyushu-u.ac.jp
authors: Yoshihiro
authors: Y
authors: Kakeji
authors: Tomonori
authors: T
authors: Nakanoko
authors: Rintaro
authors: R
authors: Yoshida
authors: Kojiro
authors: K
authors: Eto
authors: Ryuichi
authors: R
authors: Kumashiro
authors: Keisuke
authors: K
authors: Ikeda
authors: Akinori
authors: A
authors: Egashira
authors: Hiroshi
authors: H
authors: Saeki
authors: Eiji
authors: E
authors: Oki
authors: Masaru
authors: M
authors: Morita
authors: Tetsuo
authors: T
authors: Ikeda
authors: Yoshihiko
authors: Y
authors: Maehara
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D044963:Biopsy, Fine-Needle; D005260:Female; D005743:Gastrectomy / Q000379:methods*; D046152:Gastrointestinal Stromal Tumors / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery*; D006801:Humans; D010535:Laparoscopy / Q000379:methods*; D008297:Male; D008875:Middle Aged; D013274:Stomach Neoplasms / Q000601:surgery*; D025321:Surgery, Computer-Assisted / Q000379:methods; D014463:Ultrasonography