title: Laparoscopic wedge resection of the stomach for gastrointestinal stromal tumor (GIST): non-touch lesion lifting method.
abstract: BACKGROUND
  Laparoscopic surgery for GIST carries a risk of intraoperative tumor dissemination. To avoid tumor dissemination, we have utilized a "non-touch" method for surgical resection of GIST since 2000.
  
  
  METHODS
  Forty-two patients with gastric GIST were treated at our institution between 2000 and 2012. Laparoscopic wedge resection of the stomach was used as the standard procedure for tumors that were 2-5 cm in size. Tumors larger than 5 cm were treated with open surgery. Our non-touch procedure included a lesion-lifting method using traction sutures at the normal stomach wall around the tumor. Intraoperative gastroscopy was utilized to confirm the location of the tumor with laparoscopy. After lifting of the tumor, tumors with a clear operative margin were resected using a linear stapler. Tumors located at the posterior wall of the stomach or located near the esophagogastric junction were resected using traction sutures.
  
  
  RESULTS
  Median operative time was 140 min and median blood loss was 0 ml. Postoperative course was uneventful excepting one patient who experienced postoperative bleeding. The median postoperative stay was 7 days. One patient developed liver metastasis after surgery. None of the patients had local recurrence or peritoneal recurrence case.
  
  
  CONCLUSIONS
  This non-touch lesion-lifting method was useful for the surgical management of gastric GIST.
authors.affiliation: Department of Surgery, Saitama Medical Center, Jichi Medical University, Amanuma 1-847, Omiya, Saitama, 330-8503, Japan, hkiyo@omiya.jichi.ac.jp.
authors.forename: Hirokazu
authors.initials: H
authors.lastname: Kiyozaki
authors.forename: Masaaki
authors.initials: M
authors.lastname: Saito
authors.forename: Hirofumi
authors.initials: H
authors.lastname: Chiba
authors.forename: Osamu
authors.initials: O
authors.lastname: Takata
authors.forename: Toshiki
authors.initials: T
authors.lastname: Rikiyama
mesh_terms: D000328:Adult; D000368:Aged; D005260:Female; D005500:Follow-Up Studies; D005743:Gastrectomy; D046152:Gastrointestinal Stromal Tumors / Q000473:pathology / Q000601:surgery*; D006801:Humans; D010535:Laparoscopy; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D011183:Postoperative Complications; D011379:Prognosis; D013274:Stomach Neoplasms / Q000473:pathology / Q000601:surgery*