[Operative Technique for Gastric GIST According to the Tumor Location or Growth Pattern]

Gastric gastrointestinal stromal tumor(GIST)is rarely accompanied by lymph node metastasis. Therefore, partial gastrectomy generally proceeds with good indication for laparoscopic surgery. However, surgical procedures can be complicated by the tumor location or growth type. Furthermore, laparoscopy and endoscopy cooperative surgery(LECS)has recently been developed, with good results. In this study, we aimed at determining the applicability of various types of laparoscopic surgery to gastric GIST based on the tumor location and growth type. Between 2005 and 2020, 52 patients underwent surgery for preoperatively suspected or pathologically confirmed GIST. Tumors were found in the upper, middle, and lower portions of the stomach of 32, 16 and 4 patients, respectively. The types of tumor growth were intraluminal, extraluminal, and mixed for 21, 14, and 17 patients, respectively. The surgical procedures were open and laparoscopic for 26 patients each. After the laparoscopic surgery, the surgical duration, blood loss, and tumor size were significantly lower, while the hospital stay was significantly shorter. For the laparoscopic surgery, we adopted simple wedge resection, transillumination and serosal dissection methods(TSDM), or LECS. Two patients underwent TSDM using single incisional laparoscopic surgery(SILS)for tumors with intraluminal growth in the cardiac region, while 7 underwent LECS. The selection of the method for laparoscopic surgery was based on the tumor location or growth type, resulting in good outcomes.