[Gastrointestinal stromal and other mesenchymal gastric tumors--laparoscopic management?]

This study was aimed to evaluate a set of gastrointestinal stromal tumors (GIST) of the stomach managed with a laparoscopic technique (GIST).

The study covers a period from January 1,2007 until December 31, 2009 during which 12 patients underwent the laparoscopic removal of stomach tumors in the Regional Hospital in Pardubice. In all cases tumors were removed completely in a laparoscopic way, including the healthy border of the stomach tissue. The defect created in the stomach wall was sutured laparoscopically as well. On completion the sufficiency of the sutures was reviewed gastroscopically.

No death was observed in our study. Two patients suffered from wound infection (secondary healing), one of them requiring repeat surgery owing to the excessive narrowing of the distal part of the stomach. The dehiscence of the laparoscopic suture or other intraabdominal complications was not observed. 3 patients underwent chemotherapy by Imitinib. During surveillance all patients were free of signs of tumor progression or local recurrence.

Gastric GISTs are very rare tumors but their incidence is increasing. At this time the consensus about the necessity of preoperative unambiguous differentiation between malignant or less malignant variants is not available. The strict differentiation is very difficult and the determination to choose a more radical surgical approach for more malignant variants is not clear-cut.

In case of gastric GIST the local removal of a tumor with the healthy border of the stomach tissue may be chosen as an adequate approach. Our results support this local surgical approach.