Gastric Gastrointestinal stromal tumor (GISTs): Can it be effectively managed by laparoscopic resection under endoscopic guidance? (Zagazig university experience)

Amin, Khaled Mohamed; Alkilany, Mohamed; Abozaid, Eslam; Mogahed, Mohammad Farouk

doi:10.21608/zumj.2024.270059.3177

Gastric Gastrointestinal stromal tumor (GISTs): Can it be effectively managed by laparoscopic resection under endoscopic guidance? (Zagazig university experience)

Document Type : Original Article

Authors

¹ general surgery department

² Department of general surgery, faculty of medicine Zagzig university

³ Department of general surgery faculty of medicine Zagzig university

⁴ general surgery faculty of medicine zagazig university

10.21608/zumj.2024.270059.3177

Abstract

ABSTRACT

Background:

Gastrointestinal stromal tumor (GISTs) is the most common mesenchymal neoplasms of the GI tract. Surgical resection is the main treatment modality. Laparoscopic and endoscopic cooperative surgery (LECS) for gastric (GIST) was established as a type of minimal invasive resection and is now widely used worldwide.

Patients and methods:

The study is an interventional single-arm clinical trial. It was conducted in Onco- Surgery Unit, General Surgery Department, Zagazig University Hospitals with a sample size of12 cases from March to September 2023.

Results:

12 patients were eligible in this study. The operative parameters indicated that the mean operative time was170.83 minutes, and the mean blood loss was 77.92 ml. The study reported a 91% completion rate, with conversion of only one case to open surgery. All cases had free surgical margins, and there were no major complications or mortalities. The postoperative outcomes showed a mean time to first flatus of 1.58 days and a mean time to oral intake of 2.91 days. The mean postoperative hospital stay was 5.08 days. The study reported a few postoperative complications, including gastric stenosis and delayed gastric emptying one case and intraperitoneal bleeding in another case.

Conclusions

LREG is a minimally invasive and safe procedure for the resection of gastric GISTs. It offers the advantage of preserving the anatomical function of the stomach while achieving complete tumor removal with minimal margins. By combining the benefits of both laparoscopic and endoscopic techniques, LREG provides a synergistic effect that can potentially improve patient outcomes .

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