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Abstract

Gastric stromal tumors are the most common submucosal mass found in the stomach. These tumors are most often diagnosed at endoscopy and can be accurately characterized by endoscopic ultrasound. They typically require surgical resection, and an increasing number of patients undergo laparoscopic resection. A combined laparoscopic/endoscopic, intragastric enucleation technique is described, and results are reported in 10 patients. Eleven nonmalignant lesions were excised, with a mean size of 4.12 (2.0 to 7.0) cm. There were no complications, and the median length of stay was 3.5 days. This surgical approach appears appropriate for predominantly intraluminal, benign-appearing lesions of the proximal stomach. Copyright © 2001 by W.B. Saunders Company.

Keywords

Gastric stromal tumors stomach leiomyoma endoscopy laparoscopy mini-laparoscopy.

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References

Lanza FL : Benign and malignant tumors of the stomach other than carcinoma, in Haubrich WS , Schaffner F , Berk JE (eds): Gastroenterology Chapter 51, Volume 1, eds, Philadelphia, PA, WB Saunders, 1995, pp 841-858

Morgan BK , Compson C. , Talbert M. , et al: Benign smooth muscle tumors of the gastrointestinal tract. Ann Surg 211:63-66, 1990

Nakazawa S. , Yoshino J. , Nakamura T. , et al: Endoscopic ultrasonography of gastric myogenic tumor. Ultrasound Med 8:353-359, 1989

Boggino HE , Fernandez MP , Logrono R. : Cytomorphology of gastrointestinal Stromal tumor: Diagnostic role of aspiration cytology, core biopsy, and immunochemistry. Diagn Cytopathol 23:156-160, 2000.

Appelman HD : Mesenchymal tumors of the gut: Historical perspectives, new approaches, new results, and does it make any difference? Monogr Pathol (31):220-246, 1990

Appelman HD , Helwig EB : Sarcomas of the stomach. Am J Clin Pathol 67:2-10, 1977

Dougherty MJ , Compton C. , Talbert M. , et al: Sarcomas of the gastrointestinal tract. Separation into favorable and unfavorale prognostic groups by mitotic count . Ann Surg 214:569-574, 1991

Grant CS , Kim CH , Farrugia G. , et al: Gastric leiomyosarcoma. Prognostic factors and surgical management . Arch Surg 126:985-990, 1991

Lee JS , Nascimento AG , Farnell MB , et al: Epihelioid gastric stromal tumors (leiomyoblastomas): A study of fifty-five cases. Surgery 118:653-661, 1995

10.

Shiu MH , Farr GH , Papachristou DN , et al: Myosarcomas of the stomach; Natural history, prognostic factors and management. Cancer 49:177-187, 1982

11.

Tsushima K. , Rainwater LM , Goellner JR , et al: Leiomyosarcomas and benign smooth muscle tumors of the stomach: Nuclear DNA patterns studied by flow cytometry . Mayo Clin Proc 62:275-280, 1987

12.

Sanders L. , Silverman M. , Rossi R. , et al: Gastric smooth muscle tumors: Diagnostic dilemmas and factors affecting outcome. World J Surg 20:992-995, 1996

13.

Ng EH , Pollock RE , Munsell MF , et al: Prognostic factors influencing survival in gastrointestinal leiomyosarcoma. Implications for surgical management and staging. Ann Surg 215:68-77, 1992

14.

Goenka MK , Bhasin DK , Singh V. , et al: Gastric stromal tumor. Treatment by snare polypectomy. Trop Gastroenterol 17:43-46, 1996

15.

Gurbuz AT , Peetz ME : Resection of a gastric leiomyoma using combined laparoscopic and gastroscopic approach. Surg Endosc 11:285-286, 1997

16.

Taniguchi E. , Kamiike W. , Yamanishi H. , et al: Laparoscopic intragastric surgery for gastric leiomyoma. Surg Endosc 11:287-289, 1997

17.

Naitoh T. , Gagner M. : Laparoscopically assisted gastric surgery using Dexterity Pneumo Sleeve . Surg Endosc 11: 830-833, 1997

18.

Hepworth CC , Menzies D. , Motson RW : Minimally invasive surgery for posterior gastric stromal tumors. Surg Endosc 14:349-353, 2000

19.

Sekimoto M. , Tamura S. , HaSuike Y. , et al: A new technique for laparoscopic resection of a submucosal tumor on the posterior wall of the gastric fundus. Surg Endosc 13:71-74, 1999

20.

Ibrahim IM , Silvestri F. , Zingler B. : Laparoscopic resection of posterior gastric leiomyoma. Surg Endosc 11:277-279, 1997

21.

Tagaya N. , Mikami H. , Igarashi A. , et al: Laparoscopic local resection for benign nonepithelial gastric tumors. J Laparoendosc Adv Surg Tech A 7:53-58, 1997

22.

Tangoku A. , Yamamoto K. , Hirazawa K. , et al: Laparoscopic resection of large leiomyomas of the gastric fundus . Surg Endosc 13:1050-1052, 1999

23.

Heniford BT , Arca MJ , Walsh RM : The mini-laparoscopic intragastric resection of a gastroesophageal stromal tumor: A novel approach. Surg Laparosc Endosc Percutan Tech 10:82-85, 2000

24.

Barbosa J. , Maciel J. , Amarante M. , Jr: Endoscopic ultrasonography in the study of extramucosal swellings in the upper digestive tract. Surg Endosc 9:1193-1196, 1995

25.

Caletti G. , Zani L. , Bolondi L. , et al: Endoscopic ultrasonography in the diagnosis of gastric submucosal tumor. Gastrointest Endosc 35:413-418, 1989

26.

Koga H. , Ochiai A. , Nakanishi Y. , et al: Reevaluation of prognostic factors in gastric leiomyosarcoma . Am J Gastroenterol 90:1307-1312, 1995

27.

Ueyama T. , Lawamoto K. , Iwashita I. , et al: Correlation between tumor volume doubling time and histologic findings in gastric smooth muscle tumors: Clinical implications of tumor volume doubling time. J Surg Oncol 60: 12-17, 1995

Laparoendoscopic Treatment of Gastric Stromal Tumors

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