Laparoscopic management of stomach gastrointestinal stromal tumours

Abstract

Iqbal Saleem Mir, Mudasir Farooq, Abdul Qayoom, Asif Iqbal, Sheikh Viqar, Tajamul Rashid

Introduction: Stomach is the most common site of gastrointestinal stromal tumours (GIST) (40–70%) followed by small bowel and colorectum, respectively. The most definitive treatment is the surgical resection. We present our experience with eleven cases who were managed with laparoscopic resection.Methods: Patients who underwent laparoscopic resection of stomach GIST between January 2012 and January 2014 in a single surgical unit of Department of Surgery at Government Medical College Srinagar are presented here. The data ob-tained and analysed included the following characteristics: age, sex, length of postoperative hospital stay, operative time, tumour location, tumour size, histopathological assessment of resection margins, intraoperative blood loss, and incidence of perioperative complication.Results: Out of eleven patients ten patients were completely managed with laparoscopy. One patient was converted to surgery because of a large size, thus creating difficulty in manipulation. All the patients were between 50 and 65 years of age. Four tumours were located on lesser curvature, 3 on the fundus, one over anterior body, one over posterior body, and one over gastroesophageal junction. All resected specimen had tumour-free margins. Intraoperative blood loss was below 150 ml in all the patients and blood transfusion was not required in any patient. The median duration of surgery was 125 minutes (range 90-185 minutes) and median postoperative stay was 5 days (range 4-8 days). There were no immediate or late postoperative complications. There was no recurrence or distant metastasis over a median follow-up of 24 months.Conclusions: Laparoscopic resection of stomach GIST can be safely done with minimal intraoperative and postoperative complication. Besides short term benefits of minimally invasive surgery, it sticks to the principles of oncology.