Treatment Of Gastric Stromal Tumors Research Articles

Clinical observation of laparoscopic seromuscular dissection in the treatment of gastric stromal tumors

Objective To investigate the safety and oncological prognosis of laparoscopic seromuscular dissection (LSD) in the treatment of gastric stromal tumors. Material and methods From June 2016 to July 2022, 67 patients with gastric stromal tumors underwent laparoscopic seromuscular dissection (LSD), and 58 patients underwent non-LSD surgery during the same period (52 patients underwent laparoscopic gastric wedge resection (LWR), two patients underwent proximal gastrectomy, three patients underwent total gastrectomy, one patient underwent distal gastrectomy and partial hepatectomy). Gastric stromal tumor patients were compared to compare the surgical results, tumor relapse rate, and survival rate of the two groups. Results The results of the two groups were compared. For gastric stromal tumors, especially gastric stromal tumors located at ‘difficult sites’, LSD can reduce the amount of bleeding and the number of cutting staplers used during the operation, reduce the incidence of postoperative complications, shorten the postoperative hospitalization time, reduce the hospitalization cost and improve the quality of life of patients without increasing the operation time. Conclusion Laparoscopic seromuscular dissection for gastric stromal tumors is safe and technically feasible in the hands of experienced laparoscopic surgeons.

Comparison of efficacy and safety between endoscopic and laparoscopic resections in the treatment of gastric stromal tumors: a systematic review and meta-analysis.

There are still clinical controversy on the efficacy and safety of endoscopic resection (ER) and laparoscopic resection (LR) in the treatment of gastrointestinal stromal tumors (GISTs). The present study aimed to evaluate the safety and efficacy of ER in the treatment of GISTs by comparing the relative outcomes of ER to LR. PubMed, Web of Science, Cochrane Library, and Embase were searched. Data were retrieved from January 2010 to January 2020 and subjected to a meta-analysis based on the intraoperative and postoperative outcomes of ER and LR. The intervention arm was treated by LR while the comparator arm was treated by ER. Relevant literature was selected based on the inclusion criteria, data was extracted, and quality evaluation of the included literature was carried out. The Newcastle-Ottawa Scale (NOS) was applied for assessing the quality of included studies. Heterogeneity between studies was assessed using the Cochrane χ2 test and I2 statistic, and Funnel plots and Egger's test were used to detect publication bias. The present analysis included 13 studies, comprising a total of 1,261 patients, (ER vs. LR: 543 vs. 718). The incidence rate of postoperative complications [odds ratio (OR), 0.400; P=0.001] was significantly lower in the ER group [3.3%; 95% confidence interval (CI), 0.015 to 0.055] than the LR group (8.9%; 95% CI, 0.03 to 0.17). The meta-analysis revealed that the recurrence rate following ER (1.7%; 95% CI, 0.005 to 0.033) was lower than that following LR (2.5%; 95% CI, 0.012 to 0.041). The R0 resection rate of ER (99%; 95% CI, 0.975 to 0.999) was similar to that of LR (100%; 95% CI, 0.995 to 1.000). No publication bias in this study (P>0.10), and the sensitivity analysis showed that the study was robust. ER was safer and more efficient than LR in terms of all the outcomes, except the R0 resection rate. Thus, ER should be considered the treatment of choice. However, attention should be paid to the surgical margin status following ER.

The Efficacy of Endoscopic Treatment of Gastric Stromal Tumors and Its Prognostic Factors

Objective: To explore the actual effect of endoscopic treatment of gastric stromal tumors and its prognostic factors. Methods: A total of 60 patients with gastric stromal tumors who were admitted to our hospital from January 2018 to January 2019 were selected. They were divided into 2 groups according to the admission order, 30 cases each. The control group underwent conventional laparotomy, and the observation group underwent endoscopic treatment. The surgical indicators, recovery time, clinical efficacy, and complications were compared between the two groups. Result: All the surgical indicators in the observation group were better than those in the control group (P <0.05), and the recovery time of the observation group was better than the control group (P <0.05). The total incidence of complications in the group was lower than that in the control group (P <0.05). Conclusion: Endoscopic treatment of gastric stromal tumors does have exact results, and the patients have good prognosis, fewer complications, high safety, and high clinical value.

P-165 Comparative study on the clinical effect of hand-assisted laparoscopic and laparoscopic gastrectomy for gastric stromal tumor

This study aimed to compare the clinical efficacy of hand-assisted laparoscopy and laparoscopy in the treatment of gastric stromal tumors, to explore the clinical application value of hand-assisted laparoscopy in the treatment of gastric stromal tumors.

A rare case of eye complications of gastric stromal tumor treatment using imatinib mesylate

Purpose: to describe a clinical case of ocular complications of gastric stromal tumor treatment with imatinib mesylate. Material and methods . A patient aged 78 was examined by general ophthalmologic and instrumental methods, including ultrasound and spectral optical coherence tomography (SOCT). Results. Ophthalmoscopy helped diagnose a blunted foveal reflex of the right eye. In the left eye, fuzzy boundaries of the optic disc edema and the macular reflex, the presence of gray-yellow foci of an irregular shape with even distinct boundaries in the paramacular zone were revealed. In the lower part of the left eye fundus, a weakly pigmented gray-yellow focus with uneven indistinct boundaries and an uneven surface was to be seen. SOCT showed in the right eye a retinal edema in the macula and paramacular zones and an epiretinal membrane. In the left eye, SOCT showed vitreoretinal tractions and retinal edema on the edges of the optic nerve; in the paramacular zone and in the inner parts of the fundus, vitreoretinal tractions, epiretinal fibrosis, retinal edema was observed whilst in the lower parts of the fundus complete destruction of all retinal layers due to the hyperreflective focus with a small-shaped inner contour, an even choroidal profile with thinning of the choroid, vitreoretinal tractions, and epiretinal membrane in the left eye could be seen. Conclusions. The clinical case of eye complications of imatinib mesylate in the treatment of gastric stromal tumor necessitates an interdisciplinary integrated approach (involving an oncologist and an ocular oncologist) in the diagnosis and treatment of eye tumors. A complex of instrumental methods of diagnostics of eye fundus diseases involving additional refinement methods (SOCT) ensures differential diagnosis of retinopathy during the chemotherapy, secondary metastatic involvement, and vitreoretinal pathology of a different pathogenetic etiology. Early diagnosis facilitates providing adequate treatment aimed at preserving the patient’s vision, the eye, and life.

Endoscopic minimally invasive treatment of gastric stromal tumors

Gastrointestinal stromal tumor (GIST) is one of the most common tumors originating from gastrointestinal mesenchymal tissues, accounting for about 0.2% of all gastrointestinal tumors. It can occur anywhere in the gastrointestinal tract. Because gastrointestinal stromal tumors have the biological characteristics of non-directional differentiation and potential malignancy, it is very important to resect them completely in time.Traditional surgical excision has a good prognosis in the past, but it has some shortcomings, such as large trauma, slow postoperative recovery and more complications. In recent years, with the continuous development of digestive endoscopy technology, many new endoscopic techniques have emerged for the treatment of gastric stromal tumors, such as endoscopic mucosal dissection (ESD), endoscopic full-thickness resection (EFTR), endoscopy and laparoscopic combined surgery, but the safety and effectiveness of endoscopic surgery for gastric stromal tumors are still controversial in the industry. Key words: Gastrointestinal stromal tumors; Endoscopy, gastrointestinal; Review

Clinical evaluation of endoscopic resection for treatment of large gastric stromal tumors.

BACKGROUNDGastric stromal tumor is a digestive tract mesenchymal tumor with malignant potential, and endoscopic techniques have been widely used in the treatment of gastric stromal tumors, but there is still controversy over their use for large gastric stromal tumors (≥ 3 cm).AIMTo evaluate the clinical long-term efficacy and safety of endoscopic resection for large (≥ 3 cm) gastric stromal tumors.METHODSAll patients who underwent endoscopic resection or surgery at our hospital from 2012 to 2017 for pathologically confirmed gastric stromal tumor with a maximum diameter of ≥ 3 cm were collected. The clinical data, histopathologic characteristics of the tumors, and long-term outcomes were recorded.RESULTSA total of 261 patients were included, including 37 patients in the endoscopy group and 224 patients in the surgical group. In the endoscopy group, the maximum tumor diameter was 3-8 cm; the male: Female ratio was 21/16; 34 cases had low-risk tumors, 3 had intermediate-risk, and 0 had high-risk; the mean follow-up time was 30.29 ± 19.67 mo, no patient was lost to follow-up, and no patient received chemotherapy after operation; two patients with recurrence had low-risk stromal tumors, and neither had complete resection under endoscopy. In the surgical group, the maximum tumor diameter was 3-22 cm; the male: Female ratio was 121/103; 103 cases had low-risk tumors, 75 had intermediate-risk, and 46 had high-risk; the average follow-up time was 38.83 ± 21.50 mo, 53 patients were lost to follow-up, and 8 patients had recurrence after operation (6 cases had high-risk tumors, 1 had intermediate-risk, and 1 had low-risk). The average tumor volume of the endoscopy group was 26.67 ± 26.22 cm3 (3.75-120), all of which were less than 125 cm3. The average volume of the surgical group was 273.03 ± 609.74 cm3 (7-4114). Among all patients with a tumor volume < 125 cm3, 7 with high-risk stromal tumors in the surgical group (37.625 cm3 to 115.2 cm3) accounted for 3.8% (7/183); of those with a tumor volume < 125 cm3, high-risk patients accounted for 50% (39/78). We found that 57.1% (12/22) of patients with high-risk stromal tumors also had endoscopic surface ulcer bleeding and tumor liquefaction on ultrasound or abdominal computed tomography; the ratio of tumors positive for both in high-risk stromal tumors with a volume < 125 cm3 was 60% (3/5).CONCLUSIONEndoscopic treatment is safe for 95.5% of patients with gastric stromal tumors with a tumor diameter ≥ 3 cm and a volume of < 125 cm3 without endoscopic surface ulcer bleeding or CT liquefaction.

Clinical efficacy of endoscopic resection versus laparoscopic resection and open resection for gastric stromal tumor

Objective To investigate the clinical efficacy of endoscopic resection, laparoscopic resection and open resection in the treatment of gastric stromal tumor (GIST). Methods The retrospective cross-sectional study was conducted. The clinicopathological data of 254 GIST patients who were admitted to the First Affiliated Hospital of Army Medical University between January 2007 and June 2017 were collected. The endoscopic submucosal dissection (ESD) and laparoscopic or open wedge resection of GIST were performed according to the patients′ conditions. Observation indicators: (1) surgical and postoperative recovery situations; (2) postoperative pathological examination; (3) follow-up and survival situations. Follow-up using outpatient examination and telephone interview was performed to detect postoperative adjuvant therapy and survival up to June 2017. Measurement data with normal distribution were represented as ±s. Measurement data with skewed distribution were described as M (range). Results (1) Surgical and postoperative recovery situations: of 254 patients, 112 underwent ESD, including 111 with successful operation and 1 with intraoperative conversion to open surgery due to excessive bleeding-induced blurred operating view, 93 underwent successful laparoscopic wedge resection of GIST and 49 underwent successful open wedge resection of GIST. The operation time, volume of intraoperative blood loss, time for initial fluid diet intake, duration of hospital stay and hospital expenses were respectively (75±21) minutes, (6.9±0.5)mL, (2.8±0.9)days, (5.5 ± 0.2)days, (22 167±1 364)yuan in patients with ESD and (137±65)minutes, (48.1±2.6)mL, (3.9±1.4)days, (8.3 ± 2.2)days, (32 937±1 823)yuan in patients with laparoscopic operation and (168±60)minutes, (157.2±10.3)mL, (5.8±1.7)days, (11.3±3.5)days, (38 462±1 961) yuan in patients with open operation. Two patients with ESD had subcutaneous emphysema and didn′t receive special treatment, and then emphysema disappeared after 2 days. No complication was detected in patients with laparoscopic or open operations. (2) Postoperative pathological examination: tumor diameter in patients with ESD, laparoscopic operation and open operation was respectively (2.6±1.6)cm, (6.1±2.2)cm and (6.4±2.3)cm. The cases with positive CD117, discovered on GIST-1 (DOG1), CD34 and smooth muscle actin (SMA) were 106, 105, 86, 17 with ESD and 89, 87, 59, 11 with laparoscopic operation and 46, 47, 30, 8 with open operation, respectively. The extremely low risk, low risk, medium risk and high risk were respectively detected in 67, 42, 3, 0 patients with ESD and 16, 36, 23, 18 patients with laparoscopic operation and 7, 20, 14, 8 in patients with open operation. (3) Follow-up and survival situations: 210 of 254 patients were followed up for 6.0-120.0 months, with an average time of 36.0 months, including 86 with ESD, 82 with laparoscopic operation and 42 with open operation. During the follow-up, of patients with ESD, 3 patients with medium risk respectively received imatinib therapy for 7.0 months, 1.5 years and 2.0 years, and postoperative gastroscopy reexaminations every 6 months, without tumor recurrence; 81 with extremely low risk and low risk received postoperative gastroscopy reexaminations every 6 months and didn′t receive targeted therapy, without tumor recurrence; 2 died of non-stromal tumor. The postoperative average survival time, 1-, 3- and 5-year survival rates were respectively 56.3 months, 98.8%(81/82), 91.5%(75/82), 74.4% (61/82) in patients with laparoscopic surgery and 52.4 months, 97.6%(41/42), 85.7% (36/42), 81.0%(34/42) in patients with open surgery. Conclusions According to patients′ conditions, endoscopic resection, laparoscopic resection and open resection are safe and feasible in the treatment of GIST. Endoscopic resection of GIST should be selectively applied to patients with smaller diameter, with advantages of lower hospitalization expenses and better long-term prognosis. Key words: Gastric neoplasms; Stromal neoplasms; Endoscopic submucosal dissection; Surgical procedures, operative; Open resection; Laparoscopy

Long-term outcomes of endoscopic resection of gastric GISTs.

Although the endoscopic treatment of gastric stromal tumors is a recently accepted therapy, the long-term outcomes of this approach remain unknown. The aims of this study were to assess the long-term effectiveness and safety of endoscopic resection for gastric GISTs. A total of 60 consecutive patients undergoing endoscopic resection of gastric GISTs were enrolled in a retrospective single-center study. Clinical data, perioperative complications, histopathologic characteristics of the tumors, and long-term outcomes were recorded. Sixty patients successfully underwent complete resection of lesions, including 25 cases of endoscopic submucosal dissection (ESD) and 35 cases of endoscopic full-thickness resection (EFTR), with an average tumor size of 1.76±1.55cm (range 0.5-7.6cm). The average operation time was 43.97±26.95min (range 11.7-138.9min). Two cases were observed with an intraoperative hemorrhage of 200mL, which were successfully managed by hemostatic forceps. Perforations of 2-11mm of ESD occurred in four cases (4/25) and were well closed with endoclips, with no conversions to surgical operation. Mucosal laceration of esophagus occurred in 1 case, when a large tumor was removed. The average length of hospitalization was 6.50±3.06days (range 3-21days). Out of a total of 60 patients, 44 (73.3%) were at very low risk, 10 (16.7%) were at low risk, 5 (8.3%) were at intermediate risk, and 1 (1.7%) was at high risk. All patients were followed-up for 36.15±12.92months (range 14-73months). Primary tumor recurrence occurred in 1 patient who underwent a second operation after 32months, and no other cases were observed to have either tumor recurrence or metastasis. For long-term outcomes, endoscopic resection of ESD or EFTR is a safe and effective approach for removing gastric stromal tumors (<5cm), and it can be a resection technique for them with no metastasis.

Diagnosis and treatment of gastric stromal tumors

In recent years, with the detection rate of gastrointestinal cancer increasing, gastric stromal tumor attracted widespread attention. The diagnosis of gastric stromal tumor still depends on Endoscopy and Medical Imaging. Upon treatment level it not only emphasize the importance of surgery, but also highlights the molecular targeted drugs′ efficacy. Gastric stromal tumor diagnostic techniques has been updated upon traditional examination, and molecular targeted drug clinical really works to some extent, but the drug resistance and the second, the third line targeted drug therapy is still lacking lots of evidence-based medical evidence. This article will review the current treatment and treatment of gastric stromal tumor. Key words: Gastric stromal tumors; Diagnosis; Molecular targeted therapy; Imatinib; Review

Modified laparoscopic intragastric surgery and endoscopic full-thickness resection for gastric stromal tumor originating from the muscularis propria

This study aimed to evaluate the feasibility and security of the modified laparoscopic intragastric surgery (MLIGS) and the endoscopic full-thickness resection (EFR) for the treatment of gastric stromal tumors (GSTs) originating from the muscularis propria. The study population was 18 patients with GSTs of the intraluminal muscularis propria layer. Eight were treated by MLIGS performed according to the following procedures: (1) gastroscopy was used to expose and confirm the location of the tumor; (2) a laparoscope light was placed in the cavity using the trocar at the navel, with the remaining two trocars penetrating both the abdominal and stomach walls; (3) the operation was performed in the gastric lumen using laparoscopic instruments with gastroscope monitoring, and the tumor was resected; (4) the tumor tissue was removed orally using a grasping forceps; (5) and the puncture holes and perforation in the stomach were sutured using titanium clips. The remaining 10 patients were treated by EFR, which involved (1) injection of normal saline into the submucosa and precutting of the mucosal and submucosal layer around the lesion, (2) a circumferential incision as deep as the muscularis propria around the lesion, (3) an incision into the serosal layer around the lesion, (4) completion of full-thickness incision to the tumor, (5) closure of the gastric wall defect with clips. The GSTs all were resected completely. The two groups did not differ significantly in terms of tumor size, hospital stay, or abdominal pain time. But in the MLIGS group, the operation time and blood loss were significantly decreased compared with the EFR group. No postoperative complications occurred in the MLIGS group, whereas one peritoneal abscess occurred in the EFR group. The pathology of all the resected specimens showed GST. No case of implantation or metastasis was found. Both MLIGS and EFR are feasible and effective treatments for GSTs from the muscularis propria. Moreover, both are minimally invasive.

Endoscopic full-thickness resection of gastric stromal tumor arising from the muscularis propria

Background Gastric stromal tumors are the most common type of tumor originating from mesenchymal tissue. The traditional method for the treatment of gastric stromal tumor is surgical operation or therapeutic laparoscopy. More recently, endoscopic micro-traumatic surgery has become possible for gastric stromal tumors, with any perforation caused by endoscopic therapy mended endoscopically. We assessed the effectiveness of endoscopic full-thickness resection (EFR) in the treatment of gastric stromal tumors arising from the muscularis propria. Methods Of the 42 gastric stromal tumors, each &gt;2.0 cm in diameter, arising from the muscularis propria, 22 were removed by EFR and 20 by laparoscopic surgery. Tumor expression of CD34, CD117, Dog-1, S-100, and smooth muscle actin (SMA) was assessed immunohistochemically. Operating time, complete resection rate, length of hospital stay, incidence of complications, and recurrence rates were compared between the two groups. Continuous data were compared by using independent samples t-tests and categorical data by using χ2 tests. Results Comparisons of the 22 gastric stromal tumors treated with EFR and the 20 treated with laparoscopic surgery showed similar operation times (60-155 minutes (mean, (90±17) minutes) vs. 50-210 minutes (mean, (95±21) minutes), P &gt;0.05), complete resection rates (100% vs. 95%, P &gt;0.05), and length of hospital stay (4-10 days (mean, (6.0±1.8) days) vs. 4-12 days (mean, (7.3±1.7) days), P &gt;0.05). None of the patients treated with EFR experienced complications, whereas one patient treated with laparoscopy required a conversion to laparotomy and one experienced postoperative gastroparesis. No recurrences were observed in either group. Immunohistochemical staining showed that of the 42 gastric stromal tumors diagnosed by gastroscopy and endoscopic ultrasound, six were leiomyomas (SMA-positive) and the remaining 36 were stromal tumors. Conclusions Gastric stromal tumors arising from the muscularis propria can be completely removed by EFR. EFR may replace surgical or laparoscopic procedures for the removal of gastric stromal tumors.

Endoscopy-assisted laparoscopic wedge resection for the treatment of gastric stromal tumor

In recent years,minimally invasive surgery has become the mainstream trend of modern surgery with the rapid development of endoscopic and laparoscopic techniques.However,there are limitations when either technique is used alone.The laparoscopic and endoscopic cooperative surgery (LECS),which combines the advantages and makes up the deficiencies of these two techniques,has expanded the application field of minimally invasive surgery.Laparoscopic wedge resections are increasingly applied for gastric stromal tumor.Base on clinical experience of 43 patients who underwent laparoscopic wedge resections for surgical treatment of gastric stromal tumor,we conclude that this procedure is feasible and safe. Key words: Gastrointestinal stromal tumor, gastric ; Laparoscopy; Endoscopy; Gastrectomy

New-style laparoscopic and endoscopic cooperative surgery for gastric stromal tumors

To evaluate the feasibility and safety of a new style of laparoscopic and endoscopic cooperative surgery (LECS), an improved method of laparoscopic intragastric surgery (LIGS) for the treatment of gastric stromal tumors (GSTs). Six patients were treated with the new-style LECS. Surgery was performed according to the following procedures: (1) Exposing and confirming the location of the tumor with gastroscopy; (2) A laparoscopy light was placed in the cavity using the trocar at the navel, and the other two trocars penetrated both the abdominal and stomach walls; (3) With gastroscopy monitoring, the operation was carried out in the gastric lumen using laparoscopic instruments and the tumor was resected; and (4) The tumor tissue was removed orally using a gastroscopy basket, and puncture holes and perforations were sutured using titanium clips. Tumor size ranged from 2.0 to 4.5 cm (average 3.50 ± 0.84 cm). The operative time ranged from 60 to 130 min (average 83.33 ± 26.58 min). Blood loss was less than 20 mL and hospital stay ranged from 6 to 8 d (average 6.67 ± 0.82 d). The patients were allowed out of bed 12 h later. A stomach tube was inserted for 72 h after surgery, and a liquid diet was then taken. All cases had single tumors which were completely resected using the new-style LECS. No postoperative complications occurred. Pathology of all resected specimens showed GST: no cases of implantation or metastasis were found. New-style LECS for GSTs is a quick, optimized, fast recovery, safe and effective therapy.

P-0130 Clinical Characteristics Diagnosis and Treatment of 215 Cases of Gastric Stromal Tumor

ABSTRACT Introduction To investigate clinical characteristics diagnosis and treatment of gastric stromal tumor. Methods Clinical data of 215 cases of gastric stromal tumor patients from October 2007 to July 2011 were retrospectively analyzed. Results The main clinical manifestation were abdominal pain, abdominal distension, melena, abdominal mass etc. 24 cases (11.2%),102 cases (47.4%), 48 cases (22.3%), 30 cases (14.0%), 11 cases (5.1%) were located in cardia, fundus, corpus, antrum, pylorus separately. All the 215 patients received surgical resection, The very low risk were 56 cases (26.0%), low risk were 67 cases(31.2%), intermediate risk were 41 cases (19.1%) and high risk cases were 51 cases(23.7%). 138 patients with follow-up of 3 months to 35 months, 10 cases progressed, 2 patients of which died. Conclusion The main clinical manifestation exhibited no distinct characteristics. Complete surgical excision was the main therapy.

Endoscopic full-thickness resection for gastric stromal tumor

Objective To evaluate the therapeutic effect of endoscopic full-thickness resection （EFTR） for gastric stromal tumors. Methods A total of 33 patients with gastric stromal tumor origination from deep muscularis propria layer received EFTR from January 2010 to July 2011. The effectiveness and safety of EFTR were compared with those of other 34 patients with gastric stromal tumor origination from mus- calaris propria layer who underwent endoscopic submucosal dissection （ESD）. Results Except in 2 patients with lesions larger than 3.0 × 3.0 cm, EFTR was successful in others 31 patients, who recovered well and had no recurrence during the follow-up within 12 months. There were no significant differences in resection rate, incidence of complications, body temperature, white blood cell counts or recovery time between 2 procedures （P〉0.05）. However, the number of clips used in EFTR （7.0 ±3.5 vs. 4.9 ±3.1, P = 0. 013） and postoperative fasting days （3.4 ±1.5 vs. 2. 0 ± 1.0, P =0. 001 ） were significantly higher than those of ESD procedures. Conclusion EFTR is effective and safe for gastric stromal tumors with no higher risk than ESD, but it is more complex technically. EFTR can be used as an expanding method of ESD in en- doscopic treatment of gastric stromal tumors. Key words: Gastrointestinal stromal tumors ; Therapy ; Endoscopic full-thickness resection ; Endoscopic submucosal dissection

Treatment of gastric stromal tumor by a combined laparoscopic and gastroscopic approach

The combination of laparoscopy and gastroscopy makes up the defects of each of them when used alone, and further extends the application range of minimally invasive techniques. A 53-year-old patient with gastric stromal tumor was admitted to the Tenth People's Hospital of Tongji University on March 4, 2011. The result of gastroscopy showed that the tumor was at anterior wall of stomach with a size of 3.0 cm×3.5 cm. the result of CT scan preliminarily diagnosed the patient with gastric stromal tumor. Partial gastrectomy with laparoscopy combined with gastroscopy was applied to the patient on March 9, 2011. The operation time was 32 minutes and the blood loss was 10 ml. The duration of hospital stay was 4 days, and no postoperative complication occurred. Laparoscopy combined with gastroscopy for the treatment of gastric stromal tumor is feasible and safe with a favorable short-term outcome. Key words: Gastric stromal neoplasms; Laparoscopy; Gastroscopy; Gastrectomy

Application of ultrasonography in the diagnosis and treatment of gastric stromal tumors

Application of ultrasonography in the diagnosis and treatment of gastric stromal tumors

Diagnosis and treatment of gastric stromal tumors: report of 70 cases

OBJECTIVE To investigate the diagnosis and treatment of gastric stro~at tumors (GSTs), METHODS The clinical data from 70 cases with GSTs were analyzed retrospectively. RESULTS Wedge resections were performed on 32 patients and major gastrectomies on 38 patients. The median tumor size was 5,4cm in diameter and 2 out of 70 cases (2.9%) indicated positive tyrnph node metastasis. Immunohistochemical staining showed 66 out of 70 (94.3%)were positive for CD117, 53 (75.7%) positive for CD34, 24 posilive for SMA and 8 positive for Desmin and $100. Ten out o170 cases rectJrred or metastasized. The 5--year survival rate in Ibis series was 71.3%. The 5-year survival rate of benign and malignant GSTs were 92.3% and 61.8% ( P -5 cm were 95.0% and 48.4% ( P < 0.05), respectively. CONCLUSION The primary treatment for gastric stromal tumors is surgery. Tumor size and mitotic COLJnts were observed to be important prognostic indicators.