Laparoscopic Resection of Gastrointestinal Stromal Tumors (GISTs) on the Posterior Wall of the Stomach

Zhen-Ling Ji, MD, PhD, Qing-Song Tao, MD. Southeast University School of Medicine

Laparoscopic surgical techniques are benefits for wedge resection of gastrointestinal stromal tumors (GISTs). We have developed a new technique of laparoscopic transgastric resection for GISTs of the posterior wall of the stomach by using a band lifting wedge resection method, which has been confirmed to insure a sufficient surgical margin of the resected specimen in 32 cases.

GISTs were located at the posterior wall of the stomach were collected in this study. Laparoscopic anterior gastrostomy was made and a 9-Fr rubber band was looped round the tumor bases, thus the tumor was lifting up from the anterior gastrotomy. The lesion was transacted by a laparoscopic linear cutter and the gastrotomy was closed by sequential application of the linear cutters. Surgical specimens were examined immunohistochemically.

All GISTs were successfully and completely resected by laparoscopy. The resected tumors shaped ellipse or rotundity. Macroscopic examination of the resected specimen appeared complete tumor excision with negative surgical margins in all patients.

A band lifting method for transaction of a GIST on the posterior wall of the stomach can easily obtain enough surgical margins of GISTs. The technique is reliable and feasible for laparoscopic treatment for GISTs of the stomach. 

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