Single staple tissue preserving excision of intraluminal gastric GIST—preliminary case series

Abstract

: Gastro-intestinal stromal tumours (GISTs) should be resected preserving as much healthy tissue as possible while minimizing potential tumour cells dissemination. Minimally invasive wedge resection is described as a safe technique but often results in resection of an excessive amount of healthy tissue. We use an effective and easily reproducible minimally invasive technique to reduce complications due to unnecessary staple lines while preserving healthy tissue, which we describe in an educative video. This preliminary series reports the first four consecutive patients who underwent a GIST resection performed using this technique. All four patients had endoluminal gastric GISTs and were operated by the same team at the same institution (St Thomas Hospital – Guys and St Thomas NHS Foundation Trust, London) between 2018 and 2020. The technique was specifically used for endophytic bulky tumours. Average operating time was 95 minutes. Median hospital stay was two days. No significant peri- or post-operative complication was recorded and the quality of the surgical specimens was adequate. Follow up reflected UK national guidelines on GISTs according to pathological risk stratification. Single staple tissue preserving excision is a valuable and safe “no touch” technique to resect endophytic gastric GISTs and other submucosal tumours.