Identification of gastrointestinal stromal tumors from leiomyomas in the esophagogastric junction

e22512 Background: Laparoscopic surgery for small (<5 cm) gastric gastrointestinal stromal tumors (GIST) is now widely performed. However, laparoscopic resection of GIST in esophagogastric junction is technically difficult. Herein, we introduce various fashion of laparoscopic resection for small GIST in esophagogastric junction. Methods: Retrospective review of 40 consecutive patients with small GIST in esophagogastric junction who underwent attempted laparoscopic surgery. GIST in esophagogastric junction was defined as that the distance of the upper border of GIST from esophagogastric line was less than 2 cm. Three fashions of laparoscopic resection were performed: fashion A, laparoscopic wedge resection using linear stapler; fashion B, laparoscopic complete resection by opening the stomach wall and the stomach wall incision was closed with suture; fashion C, laparoscopic proximal gastrectomy with pyloroplasty. The data of clinicopathologic characteristics, operative course and short-term outcomes were analyzed. Results: All procedures were finished successfully and no operative relatively complication was recorded. Tumor in 24/40 (60%) patients was located in greater curvature. 70.1% (17/24) of them received fashion A and others (7/24) underwent fashion B. Tumor in 16/40 (40%) patients was located in lesser curvature. 18.8% (3/16) of them underwent fashion C and others (13/16) underwent fashion B. The mean operative time was 97.4±21.3 min and the mean estimated blood loss was 20.5±10.4 ml. The mean first time of flatus was 39.2±10.0 hours and the time of fluid intake was 40.1±11.7 hours. The mean hospital stay was 4.2±1.3 days. The mean diameter of tumor was 2.7±1.0 cm. Conclusions: Laparoscopic surgery for small GIST in esophagogastric junction is safe and feasible. The selection of various laparoscopic resection fashions was according to the tumor location.

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“Seedling” Mesenchymal Tumors (Gastrointestinal Stromal Tumors and Leiomyomas) are Common Incidental Tumors of the Esophagogastric Junction

The American Journal of Surgical Pathology ◽

10.1097/pas.0b013e31806ab2c3 ◽

2007 ◽

Vol 31 (11) ◽

pp. 1629-1635 ◽

Cited By ~ 86

Author(s):

Susan C. Abraham ◽

Alyssa M. Krasinskas ◽

Wayne L. Hofstetter ◽

Stephen G. Swisher ◽

Tsung-Teh Wu

Keyword(s):

Gastrointestinal Stromal Tumors ◽

Esophagogastric Junction ◽

Mesenchymal Tumors ◽

Stromal Tumors

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Laparoscopic wedge resection for gastrointestinal stromal tumors adjacent to the esophagogastric junction or posterior fundus wall

ASVIDE ◽

10.21037/asvide.2018.840 ◽

2018 ◽

Vol 5 ◽

pp. 840-840

Author(s):

Francisco Berrospi-Espinoza ◽

Ramiro M. Fernández-Placencia ◽

Eloy Ruiz-Figueroa

Keyword(s):

Gastrointestinal Stromal Tumors ◽

Esophagogastric Junction ◽

Wedge Resection ◽

Laparoscopic Wedge Resection ◽

Stromal Tumors

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Safety of laparoscopic local resection for gastrointestinal stromal tumors near the esophagogastric junction

Surgery Today ◽

10.1007/s00595-021-02345-y ◽

2021 ◽

Author(s):

Kohei Tanigawa ◽

Shingo Kanaji ◽

Ryuichiro Sawada ◽

Hitoshi Harada ◽

Naoki Urakawa ◽

...

Keyword(s):

Gastrointestinal Stromal Tumors ◽

Esophagogastric Junction ◽

Local Resection ◽

Stromal Tumors ◽

Laparoscopic Local Resection

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Laparoscopic vs. open surgery for gastrointestinal stromal tumors of esophagogastric junction: A multicenter, retrospective cohort analysis with propensity score weighting

Chinese Journal of Cancer Research ◽

10.21147/j.issn.1000-9604.2021.01.05 ◽

2021 ◽

Vol 33 (1) ◽

pp. 42-52

Author(s):

Wenjun Xiong ◽

◽

Yuting Xu ◽

Tao Chen ◽

Xingyu Feng ◽

...

Keyword(s):

Propensity Score ◽

Gastrointestinal Stromal Tumors ◽

Retrospective Cohort ◽

Open Surgery ◽

Esophagogastric Junction ◽

Cohort Analysis ◽

Stromal Tumors ◽

Propensity Score Weighting ◽

Retrospective Cohort Analysis

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Nomogram for Predicting Risk of Esophagogastric Junction (EGJ) Resection During Laparoscopic Resection of Gastrointestinal Stromal Tumors in EGJ: A Retrospective Multicenter Study

Frontiers in Surgery ◽

10.3389/fsurg.2021.712984 ◽

2021 ◽

Vol 8 ◽

Author(s):

Yuting Xu ◽

Lijie Luo ◽

Xingyu Feng ◽

Yensheng Zheng ◽

Tao Chen ◽

...

Keyword(s):

Laparoscopic Surgery ◽

Multicenter Study ◽

Tumor Size ◽

Gastrointestinal Stromal Tumors ◽

Esophagogastric Junction ◽

Distant Metastases ◽

Stromal Tumors ◽

Surgical Methods ◽

Medical University ◽

Retrospective Multicenter Study

Background: The established criteria for determining whether to excise the cardia during laparoscopic surgery for gastrointestinal stromal tumors in the esophagogastric junction (EGJ-GISTs) remain controversial. This retrospective multicenter study was conducted to develop a nomogram for predicting the risk of the cardia excision during laparoscopic surgery for EGJ-GISTs.Material and Methods: We reviewed data from 2,127 gastric-GISTs (g-GISTs) patients without distant metastases in four hospital between June 2012 and June 2020. Of those, according to the including criteria, 184 patients [Guangdong Provincial Hospital of Chinese Medicine (n = 81), Nanfang Hospital of Southern Medical University (n = 60), Guangdong General Hospital (n = 34), and The Third Affiliated Hospital of Southern Medical University (n = 9)] with EGJ-GISTs were identified and included in this study. Factors contributing to risk of cardia excision were identified and used to create a nomogram. Nomogram performance was assessed using a bootstrapped concordance index (c-index) and calibration plots.Results: According to the multivariate analysis, the distance from the margin of the tumor to the esophagogastric line (EG-line) (cm) (OR = 0.001, 95% CI: 0.00001~0.056, P = 0.001) and tumor size (cm) (OR = 14.969, 95% CI: 1.876~119.410, P = 0.011) were significantly related to likelihood of cardia structure excision in laparoscopic surgery for EGJ-GISTs. These two factors were used to generate a nomogram for predicting risk of cardia excision using a logistic regression model; a bootstrapped C-index of 0.988 (calibrated C-index = 0.987) indicated strong predictive ability, with broad calibration.Conclusions: This nomogram based on distance from tumor margin to EG-line and tumor size may serve as a tool for predicting risk of cardia damage during laparoscopic removal of EGJ-GISTs to aid in selection of surgical methods and preoperative neoadjuvant therapy.

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