Surgical treatment of gastric stromal tumors (review of eleven patients)

Asem Ghasoup, MD, Omar Sadieh, MD, Qais Al Ani, FRCS, Amer Hashim, FRCS

Al Bashir Hospital,M.O.H-Jordan

Background: Gastrointestinal stromal tumor (GIST) is a rare neoplasm exhibiting, in most cases, mutations of c-kit tyrosine kinase, it is the most common mesenchymal tumor of the gastrointestinal tract. Two thirds of all gut malignant GISTs occur in the stomach.

Methods: 11 patients presented with GIST tumors from the period of Jan. 2004 to Feb. 2012. Seven males and four females, the age range from 21 years to 64 years. Surgical treatment done in all patients with local Gastric wedge resection done in 4 patients, subtotal gastrectomy in 3 ,total gastrectomy in 2, laparoscopic proximal gastrectomy in one ,distal gastrectomy in one patient ,(Glevec)imatinib 400mg twice daily used preoperatively in advanced 4 patients and postoperatively in 5 patients.

Results: Patients presented with upper gastrointestinal bleeding in 4 patients, abdominal mass and weight loss in 3, dysphagia in 2 patients, While one patient presented acutely with haemoperitoneum. Preoperative diagnosis done in 4 patients as gastric GIST, while in the remainder the diagnosis was done postoperatively. Tumor located in the cardia of the stomach in 2 paients, body of the stomach in 6 patients and the antrum in 2 patients. There was no operative mortality.

Conclusions: The therapy of choice of resectable GIST is complete surgical removal of the tumor. Lymphadenectomy is not necessary; GIST rarely involves the loco regional lymph nodes. The margins of resection from the tumor specimen should be carefully oriented and examined.

Session: Poster Presentation

Program Number: P198

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