Exploration of Different Managements for Resection of Gastric Stromal Tumor by Single Incision Laparoscopic Surgery_CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Authors：

 KONGJing ,  WUShuo-dong , LIUBin-bin , SUYang , WANGYu , JIANGQing-quan , GUOEn-ling

Department of Minimally Invasive Surgery, Shengjing Hospital of China Medical University, Shenyang 110004, Liaoning Province, China;

Corresponding author：

WUShuo-dong, Email: wusd@sj-hospital.org

Keywords：

Gastric stromal tumor; Single incision laparoscopic surgery; Wedge resection of stomach; Subtotal gastrectomy

DOI：

10.7507/1007-9424.20140333

Video：

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Objective To summarize the procedure of transumbilical single incision laparoscopic surgery (SILS) with conventional laparoscopic instruments for different tumor diameter and different site of gastric stromal tumor. Method The clinical data, intraoperative procedure, and postoperative recovery of 34 patients with gastric stromal tumor from December 2009 to February 2014 in this hospital were analyzed retrospectively. Results The transumbilical SILS was performed successfully in all the 34 patients.Among these patients, the wedge resection of stomach was perfor-med in 27 patients, distal subtotal gastrectomy was performed in 6 patients, distal subtotal gastrectomy complicated with multivisceral resection was performed in 1 patient.The pathology confirmed that the diameter of tumors was from 0.6 cm to 10.0 cm (average 3.4 cm).The resection margins were tumor free.The risk assessment showed that tumors with extremely low risk were in 9 cases, low risk were in 17 cases, intermediate risk were in 6 cases, high risk were in 2 cases.During surgery, 9 tumors were located on the fundus of stomach, 6 tumors on the gastric greater curvature, 7 tumors on the gastric lesser curvature, 2 tumors on the anterior and posterior wall of the stomach respectively, 3 tumors on the cardia below, 4 tumors on the gastric antrum, tumor invaded the surrounding organs in 1 case.There was no conversion to open or conventional laparoscopic surgery.no intraoperative or postoperative complications were experi-enced in all the patients except one was postoperative intraperitoneal bleeding and one was incision infection.All the patients were followed for an average of 25 months (range 3-49 months), there was no evident recurrence of disease. Conclusions The transumbilical SILS for gastric stromal tumor is a feasible and safe technique when performed by an experienced laparoscopic surgeon.The suitable procedure of SILS should be selected for gastric stromal tumor according their different size and location.

Citation： KONGJing, WUShuo-dong, LIUBin-bin, SUYang, WANGYu, JIANGQing-quan, GUOEn-ling. Exploration of Different Managements for Resection of Gastric Stromal Tumor by Single Incision Laparoscopic Surgery. CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY, 2014, 21(11): 1396-1400. doi: 10.7507/1007-9424.20140333 Copy

1.	李雪兰, 胡忠良, 郑长怡, 等.胃肠道间质瘤的病理与免疫组化特征:附20例报告[J].中国普通外科杂志, 2005, 14(3):221-224.
2.	晏仲舒.胃肠道基质瘤[J].中国普通外科杂志, 2003, 12(4):243-244.
3.	Na JU, Lee SI, Noh SM.The single incision laparoscopic intragastric wedge resection of gastric submucosal tumor[J].J Gastric Cancer, 2011, 11(4):225-229.
4.	Wu SD, Kong J, Su Y, et al.Safety and application of transumbilical single-incision laparoscopic gastrectomy for GIST:SILS in benign gastric disease[J].Surg Innov, 2013, 20(4):365-369.
5.	Hirano Y, Watanabe T, Uchida T, et al.Laparoendoscopic single site partial resection of the stomach for gastrointestinal stromal tumor[J].Surg Laparosc Endosc Percutan Tech, 2010, 20(4):262-264.
6.	Henckens T, Van de Putte D, Van Renterghem K, et al.Laparoendoscopic single-site gastrectomy for a gastric GIST using double-bended instruments[J].J Laparoendosc Adv Surg Tech A, 2010, 20(5):469-471.
7.	Dapri G, Ntounda R, Himpens J, et al.Single-incision transumbilical laparo-endoscopic gastric benign tumor resection[J].Ann Surg Oncol, 2011, 18(1):191.
8.	Sasaki A, Koeda K, Nakajima J, et al.Single-incision laparoscopic gastric resection for submucosal tumors:report of three cases[J].Surg Today, 2011, 41(1):133-136.
9.	Takahashi T, Takeuchi H, Kawakubo H, et al.Single-incision laparoscopic surgery for partial gastrectomy in patients with a gastric submucosal tumor[J].Am Surg, 2012, 78(4):447-450.
10.	Patrzyk M, Glitsch A, Schreiber A, et al.Single-port versus standard laparoscopic resection for a gastric benign tumor in gastroscopic-laparoscopic rendezvous procedures using a laser-supported diaphanoscopy[J].Surg Laparosc Endosc Percutan Tech, 2013, 23(4):400-405.
11.	Orozakunov E, Akyol C, Tantoglu U, et al.Surgical glove-port single-incision laparoscopic gastric wedge resection of gastrointestinal stromal tumors:initial experience with 2 cases[J].Surg Laparosc Endosc Percutan Tech, 2013, 23(4):e160-e161.
12.	王荣, 江志伟, 高勇, 等.单孔腹腔镜胃间质瘤切除术15例报告[J].腹腔镜外科杂志, 2012, 17(5):346-348.
13.	刘长青, 谭诗云, 李军华, 等.超声内镜联合CT对胃间质瘤的临床诊断价值[J].世界华人消化杂志, 2012, 20(25):2404-2406.
14.	Gervaz P, Huber O, Morel P.Surgical management of gastrointestinal stromal tumours[J].Br J Surg, 2009, 96(6):567-578.
15.	Ng EH, Pollock RE, Munsell MF, et al.Prognostic factors influencing survival in gastrointestinal leiomyosarcomas.Implications for surgical management and staging[J].Ann Surg, 1992, 215(1):68-77.
16.	罗国德, 龚加庆, 张林, 等.腹腔镜胃部分切除术治疗胃间质瘤22例[J].中国普外基础与临床杂志, 2010, 17(10):1014-1016.
17.	Lukaszczyk JJ, Preletz RJ.Laparoscopic resection of benign stromal tumor of the stomach[J].J Laparoendosc Surg, 1992, 2(6):331-334.
18.	Matsuhashi N, Osada S, Yamaguchi K, et al.Long-term outcomes of treatment of gastric gastrointestinal stromal tumor by laparoscopic surgery:review of the literature and our experience[J].Hepatogastroenterology, 2014, 60(128):2011-2015.
19.	Honda M, Hiki N, Nunobe S, et al.Long-term and surgical outcomes of laparoscopic surgery for gastric gastrointestinal stromal tumors[J].Surg Endosc, 2014, 28(8):2317-2322.
20.	Tabrizian P, Sweeney RE, Uhr JH, et al.Laparoscopic resection of gastric and small bowel gastrointestinal stromal tumors:10-year experience at a single center[J].J Am Coll Surg, 2014, 218(3):367-373.
21.	刘雁军, 张抒, 孙晓斌, 等.经脐单孔腹腔镜联合胃镜治疗微小胃间质瘤30例临床分析[J].中国普外基础与临床杂志, 2011, 18(11):1209-1211.
22.	秦诚, 陈延林, 何德云, 等.完全腹腔镜手术联合术中经口腔取出标本法治疗胃间质瘤[J].中国普外基础与临床杂志, 2012, 19(8):871-873.
23.	Koh YX, Chok AY, Zheng HL, et al.A systematic review and meta-analysis comparing laparoscopic versus open gastric resections for gastrointestinal stromal tumors of the stomach[J].Ann Surg Oncol, 2013, 20(11):3549-3560.
24.	孔静, 吴硕东, 陈永生, 等.单切口与常规腹腔镜胃楔形切除术治疗胃间质瘤的对比研究[J].中国内镜杂志, 2013, 19(11):1154-1156.
25.	吴斌, 邱辉忠, 肖毅, 等.胃间质瘤的手术治疗[J].中国现代手术学杂志, 2005, 9(3):183-185.

1. 李雪兰, 胡忠良, 郑长怡, 等.胃肠道间质瘤的病理与免疫组化特征:附20例报告[J].中国普通外科杂志, 2005, 14(3):221-224.
2. 晏仲舒.胃肠道基质瘤[J].中国普通外科杂志, 2003, 12(4):243-244.
3. Na JU, Lee SI, Noh SM.The single incision laparoscopic intragastric wedge resection of gastric submucosal tumor[J].J Gastric Cancer, 2011, 11(4):225-229.
4. Wu SD, Kong J, Su Y, et al.Safety and application of transumbilical single-incision laparoscopic gastrectomy for GIST:SILS in benign gastric disease[J].Surg Innov, 2013, 20(4):365-369.
5. Hirano Y, Watanabe T, Uchida T, et al.Laparoendoscopic single site partial resection of the stomach for gastrointestinal stromal tumor[J].Surg Laparosc Endosc Percutan Tech, 2010, 20(4):262-264.
6. Henckens T, Van de Putte D, Van Renterghem K, et al.Laparoendoscopic single-site gastrectomy for a gastric GIST using double-bended instruments[J].J Laparoendosc Adv Surg Tech A, 2010, 20(5):469-471.
7. Dapri G, Ntounda R, Himpens J, et al.Single-incision transumbilical laparo-endoscopic gastric benign tumor resection[J].Ann Surg Oncol, 2011, 18(1):191.
8. Sasaki A, Koeda K, Nakajima J, et al.Single-incision laparoscopic gastric resection for submucosal tumors:report of three cases[J].Surg Today, 2011, 41(1):133-136.
9. Takahashi T, Takeuchi H, Kawakubo H, et al.Single-incision laparoscopic surgery for partial gastrectomy in patients with a gastric submucosal tumor[J].Am Surg, 2012, 78(4):447-450.
10. Patrzyk M, Glitsch A, Schreiber A, et al.Single-port versus standard laparoscopic resection for a gastric benign tumor in gastroscopic-laparoscopic rendezvous procedures using a laser-supported diaphanoscopy[J].Surg Laparosc Endosc Percutan Tech, 2013, 23(4):400-405.
11. Orozakunov E, Akyol C, Tantoglu U, et al.Surgical glove-port single-incision laparoscopic gastric wedge resection of gastrointestinal stromal tumors:initial experience with 2 cases[J].Surg Laparosc Endosc Percutan Tech, 2013, 23(4):e160-e161.
12. 王荣, 江志伟, 高勇, 等.单孔腹腔镜胃间质瘤切除术15例报告[J].腹腔镜外科杂志, 2012, 17(5):346-348.
13. 刘长青, 谭诗云, 李军华, 等.超声内镜联合CT对胃间质瘤的临床诊断价值[J].世界华人消化杂志, 2012, 20(25):2404-2406.
14. Gervaz P, Huber O, Morel P.Surgical management of gastrointestinal stromal tumours[J].Br J Surg, 2009, 96(6):567-578.
15. Ng EH, Pollock RE, Munsell MF, et al.Prognostic factors influencing survival in gastrointestinal leiomyosarcomas.Implications for surgical management and staging[J].Ann Surg, 1992, 215(1):68-77.
16. 罗国德, 龚加庆, 张林, 等.腹腔镜胃部分切除术治疗胃间质瘤22例[J].中国普外基础与临床杂志, 2010, 17(10):1014-1016.
17. Lukaszczyk JJ, Preletz RJ.Laparoscopic resection of benign stromal tumor of the stomach[J].J Laparoendosc Surg, 1992, 2(6):331-334.
18. Matsuhashi N, Osada S, Yamaguchi K, et al.Long-term outcomes of treatment of gastric gastrointestinal stromal tumor by laparoscopic surgery:review of the literature and our experience[J].Hepatogastroenterology, 2014, 60(128):2011-2015.
19. Honda M, Hiki N, Nunobe S, et al.Long-term and surgical outcomes of laparoscopic surgery for gastric gastrointestinal stromal tumors[J].Surg Endosc, 2014, 28(8):2317-2322.
20. Tabrizian P, Sweeney RE, Uhr JH, et al.Laparoscopic resection of gastric and small bowel gastrointestinal stromal tumors:10-year experience at a single center[J].J Am Coll Surg, 2014, 218(3):367-373.
21. 刘雁军, 张抒, 孙晓斌, 等.经脐单孔腹腔镜联合胃镜治疗微小胃间质瘤30例临床分析[J].中国普外基础与临床杂志, 2011, 18(11):1209-1211.
22. 秦诚, 陈延林, 何德云, 等.完全腹腔镜手术联合术中经口腔取出标本法治疗胃间质瘤[J].中国普外基础与临床杂志, 2012, 19(8):871-873.
23. Koh YX, Chok AY, Zheng HL, et al.A systematic review and meta-analysis comparing laparoscopic versus open gastric resections for gastrointestinal stromal tumors of the stomach[J].Ann Surg Oncol, 2013, 20(11):3549-3560.
24. 孔静, 吴硕东, 陈永生, 等.单切口与常规腹腔镜胃楔形切除术治疗胃间质瘤的对比研究[J].中国内镜杂志, 2013, 19(11):1154-1156.
25. 吴斌, 邱辉忠, 肖毅, 等.胃间质瘤的手术治疗[J].中国现代手术学杂志, 2005, 9(3):183-185.

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Exploration of Different Managements for Resection of Gastric Stromal Tumor by Single Incision Laparoscopic Surgery

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