Laparoscopic gastric wedge resection as the method of choice in the treatment of gastrointestinal stromal tumors: A case report
2016
Introduction. The gastrointestinal stromal tumors (GIST) are the most
frequent mesenchymal tumors of the gastrointestinal tract. The surgery of
resectable gastric GIST is the primary therapy for these tumors, but the
decision regarding the surgical radicality of the procedures is still a point
of discussion among surgeons and oncologists. Case Outline. A 74-year-old
patient was admitted to hospital with signs of bleeding from the upper parts
of the gastrointestinal tract. Urgent gastroscopy was performed and a
subepithelial gastric lesion with bleeding ulceration was noted in the region
of the fornix. A computed tomography scan of the abdomen showed a tumor in
the fornix region with the dimensions of 48 Ч 32 mm, which was growing mostly
intraluminally. After an adequate preoperative preparation the patient
underwent a laparoscopic wedge resection of gastric fornix with intramural
tumor lesion. The histopathological analysis of the specimen showed a well
differentiated GIST (histological grade G1), of the spindle cell type. Based
on the immunohistochemical analysis of the specimen it was concluded that the
patient was in the IA stage of the disease with a low risk of malignant
progression. In the population of patients with GIST, this is the most common
group (43%), with low malignant potential, and relapses present in only 3.6%
of cases. The patient started with oral food intake on the first
postoperative day, the first bowel movement occurred 36 hours after surgery,
and the patient was released from hospital on the fourth postoperative day.
Conclusion. Based on the aforementioned, we consider that the laparoscopic
gastric wedge resection is a safe and efficient surgical procedure. This is
primary therapy for most common group of patients with resectable gastric
GIST.
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