Wenjun Xiong, Jin Wan. Guangdong Province Hospital of Chinese Medicine, the Second Affiliated Hospital of Guangzhou University of Chinese Medicine
Objective: Laparoscopic surgery for small (<5 cm) gastric gastrointestinal stromal tumors (GIST) is now widely performed. However, laparoscopic resection of GIST in easophagogastric junction is technically difficult. Herein, we introduce various fashion of laparoscopic resection for small GIST in easophagogastric junction.
Methods: Retrospective review of 40 consecutive patients with small GIST in easophagogastric junction who underwent attempted laparoscopic surgery. GIST in easophagogastric junction was defined as that the distance of the upper border of GIST from easophagogastric line was less than 2 cm. Three fashions of laparoscopic resection were performed: fashion A, laparoscopic wedge resection using linear stapler; fashion B, laparoscopic complete resection by opening the stomach wall and the stomach wall incision was closed with suture; fashion C, laparoscopic proximal gastrectomy with pyloroplasty. The data of clinicopathologic characteristics, operative course and short-term outcomes were analyzed.
Results: All procedures were finished successfully and no operative relatively complication was recorded. Tumor in 24/40 (60%) patients was located in greater curvature. 70.1% (17/24) of them received fashion A and others (7/24) underwent fashion B. Tumor in 16/40 (40&) patients was located in lesser curvature. 18.8% (3/16) of them underwent fashion C and others (13/16) underwent fashion B. The mean operative time was 97.4±21.3 min and the mean estimated blood loss was 20.5±10.4 ml. The mean first time of flatus was 39.2±10.0 hours and the time of fluid intake was 40.1±11.7 hours. The mean hospital stay was 4.2±1.3 days. The mean diameter of tumor was 2.7±1.0 cm.
Conclusions: Laparoscopic surgery for small GIST in easophagogastric junction is safe and feasible. The selection of various laparoscopic resection fashions was according to the tumor location.
Presented at the SAGES 2017 Annual Meeting in Houston, TX.
Abstract ID: 79967
Program Number: S032
Presentation Session: Gastric
Presentation Type: Podium