scholarly journals “Dovetail” gastric resection: a novel model in the treatment of gastrointestinal stromal tumors

2020 ◽  
Vol 2 (4) ◽  
pp. First
Author(s):  
Denise Gambardella ◽  
Angelo Aldo Schicchi ◽  
Andrea Boccuto ◽  
Vito Bilotta ◽  
Ettore Caruso ◽  
...  
Keyword(s):  
Gastrointestinal Stromal Tumors ◽  
Open Surgery ◽  
Gastric Resection ◽  
Gastric Antrum ◽  
Gastric Gist ◽  
Stromal Tumors ◽  
Frequent Site ◽  
Subepithelial Lesions ◽  
Technical Solutions ◽  
Preoperative Examination

Gastrointestinal stromal tumors (GISTs) are the most common malignant subepithelial lesions of the gastrointestinal tract. The prognosis of this disease is associated with the tumor size and mitotic index. The standard treatment of a GIST without metastasis is surgical resection. The stomach is the most frequent site of the disease and many technical solutions have recently been proposed as shown also by the dramatic increase in publications on this field. There are many studies that suggest laparoscopy may be an acceptable surgical treatment option compared to open surgery for gastric GIST. However, open surgery assumes great importance in large tumors located in difficult to access locations. Here, we present a case involving a 60-year-old man who was diagnosed with gastric antrum GIST, according to a preoperative examination and postoperative pathology. Then, the patient successfully underwent an atypical gastric resection. We proposed a novel surgical technique to be considered in case of gastric benign disease or GIST localized at the gastric antrum.

scholarly journals The prognostic value of gender in gastric gastrointestinal stromal tumors: A propensity score matching analysis.

2020 ◽  
Author(s):  
Jian fang Rong ◽  
Si hai Chen ◽  
Cong hua Song ◽  
Huan Wang ◽  
Qiao yun Zhao ◽  
...  
Keyword(s):  
Propensity Score ◽  
Propensity Score Matching ◽  
Gastrointestinal Stromal Tumors ◽  
Gastric Gist ◽  
Confounding Factors ◽  
Cox Regression Analysis ◽  
Stromal Tumors ◽  
Female Patients ◽  
Risk Of Death ◽  
Male Patients

Abstract Background Gastrointestinal stromal tumors (GISTs) of the stomach are the most common GISTs. The risk, incidence and outcome of cancer are different between the sexes. Whether gender is related to the prognosis of gastric stromal tumors is unclear. Therefore, this study aims to explore the relationship between gender and gastric GIST prognosis. Methods Data from gastric GIST patients were collected from the Surveillance, Epidemiology, and End Results (SEER) database. After propensity score matching (PSM) was performed to reduce confounding factors, the clinicopathological features and prognosis of GIST patients were comprehensively evaluated. Results There were 512 male patients and 538 female patients with gastric GIST. The gender of gastric GIST patients was associated with marital status, surgical treatment, tumor size, and mitotic index (P < 0.05). The Kaplan-Meier analysis and log-rank test revealed that male patients had a higher mortality rate than female patients (P = 0.0024). After matching all the potential confounding factors, the survival of the female gastric GIST patients was better than that of the male gastric GIST patients (P = 0.042). Cox regression analysis revealed that gender was an independent risk factor for overall survival. The risk of death was higher for males than for females (HR: 1.539, 95% CI: 1.066–2.222, P = 0.021). Conclusion Gender could be a prognostic factor for gastric GIST survival, and male patients had a higher risk of death.

Gastrointestinal Stromal Tumors: Actin Expression, a New Prognostic Factor?

2010 ◽  
Vol 76 (11) ◽  
pp. 1244-1250 ◽  
Author(s):  
Jaime Ruiz-Tovar ◽  
María Diez-Tabernilla ◽  
Gada Housari ◽  
Enrique Martinez-Molina ◽  
Alfonso Sanjuanbenito
Keyword(s):  
Prognostic Factors ◽  
Small Bowel ◽  
Gastrointestinal Stromal Tumors ◽  
Abdominal Mass ◽  
Disease Free Survival ◽  
Gastric Gist ◽  
Free Survival ◽  
Stromal Tumors ◽  
Actin Expression ◽  
Disease Free

The aim of this study is to analyze the clinical outcome of gastrointestinal stromal tumors (GISTs) and to determine new prognostic factors. We perform a retrospective study of all the patients diagnosed with GIST in any location and operated on between 2000 and 2008 at our institution. We analyzed 35 patients, 16 males (45.7%) and 19 females (54.3%), with a mean age of 64 ± 13.8 years. The tumors were located in the stomach in 22 patients (62.9%), in the small bowel in 10 (28.6%), and the retroperitoneum in three (8.6%). Referring to gastric GIST, endoscopy revealed an ulceration in the mucosa in five cases, suggesting an epithelial neoplasm. In all these cases, pathology of the biopsy specimen was nonconclusive. Survival rate at 1 and 5 years was 94.3 and 88.6 per cent, respectively. Disease-free survival at 1 and 2 years was 91.4 and 88.6 per cent, respectively. Analyzing prognostic factors, a lower disease-free survival was observed among patients with constitutional syndrome at diagnosis ( P = 0.000), small bowel GIST ( P = 0.037), and tumors not expressing actin ( P = 0.015). A lower global survival was observed among men ( P = 0,036), patients with an abdominal mass ( P = 0.033) or with constitutional syndrome ( P = 0.007) at diagnosis and tumors at a retroperitoneal location ( P = 0.0002). Gastric GIST may be confused with epithelial neoplasms, modifying the surgery. In our patients, masculine gender, constitutional syndrome and abdominal mass at diagnosis, small bowel and retroperitoneal location, and actin negative tumors are bad prognostic factors.

Presentation and Management of Gastrointestinal Stromal Tumors of the Duodenum

2006 ◽  
Vol 72 (8) ◽  
pp. 719-723 ◽  
Author(s):  
Robert D. Winfield ◽  
Steven N. Hochwald ◽  
Stephen B. Vogel ◽  
Alan W. Hemming ◽  
Chen Liu ◽  
...  
Keyword(s):  
Small Bowel ◽  
Gastrointestinal Stromal Tumors ◽  
Incidental Finding ◽  
Case Reports ◽  
Complete Removal ◽  
Gastric Gist ◽  
Stromal Tumors ◽  
Duodenal Gist ◽  
Median Size ◽  
Duodenal Resection

Duodenal gastrointestinal stromal tumors (GIST) have been described primarily in isolated case reports. In order to learn more about duodenal GIST, a retrospective review of patients with GIST managed at a single institution between 2000 and 2005 was conducted. Thirty-eight GIST of the stomach and small bowel were analyzed. Eight (21%) were duodenal GIST. The median size of duodenal GIST (6.0 cm) and small bowel GIST (6.3 cm) was larger than the median size of gastric GIST (3.0 cm). The most common presentation of duodenal GIST was bleeding (50%) which was similar to other small bowel GIST (49%) but different from gastric GIST which were most commonly an incidental finding (62%). Two patients (25%) with duodenal GIST had a history of neurofibromatosis. The duodenal GIST were located in the 2nd (n = 5, 63%) and 3rd portion of duodenum (n = 3, 37%). Seven of 8 patients underwent complete resection of duodenal GIST. Pancreaticoduodenectomy was the most common operation performed (n = 5); 2 patients were treated with partial duodenal resection. No patients undergoing pancreaticoduodenectomy (n = 5) were found to have lymph node metastases. No patients received neo-adjuvant or adjuvant therapy with Imatinib. Following resection, 2 patients have recurred (12 and 48 mo.), 4 patients are without disease (1, 6, 6, and 24 mo.), 1 patient died postoperatively. Duodenal GIST are relatively rare tumors that present most commonly with gastrointestinal bleeding. Duodenal GIST are associated with neurofibromatosis. Many duodenal GIST require pancreaticoduodenectomy for complete removal.

scholarly journals Early gastric cancer with three gastric gastrointestinal stromal tumors combined with synchronous colon cancer: a case report

2020 ◽  
Vol 18 (1) ◽  
Author(s):  
Sung Chul Lee ◽  
Kwangwoo Nam ◽  
Dajeong Nam ◽  
Min A Kwon ◽  
Dong-Wook Kim
Keyword(s):  
Gastric Cancer ◽  
Colon Cancer ◽  
Early Gastric Cancer ◽  
Gastrointestinal Stromal Tumors ◽  
Upper Body ◽  
Wall Thickening ◽  
Gastric Gist ◽  
Stromal Tumors ◽  
Lesser Curvature ◽  
Synchronous Colon Cancer

Abstract Background There have been very few reports of patients with early gastric cancer (EGC) and colorectal cancer combined with gastric gastrointestinal stromal tumors (GISTs). Case presentation We report the case of a patient with multiple tumors that were found at the same time in the abdomen. The patient was a 77-year-old man who was referred for a gastric GIST. Esophagogastroduodenoscopy showed the known lesion (a gastric GIST) on the lesser curvature of the upper body and a new lesion on the lesser curvature of the lower body of the stomach with suspicion of EGC. Computed tomography findings confirmed the presence of a GIST in the stomach and revealed two new lesions. One of these lesions was suspected to be a 4-cm submucosal tumor on the anterior wall of the upper body of the stomach. The other was a wall thickening of the descending colon that demonstrated the possibility of malignancy. Synchronous colon cancer was confirmed on colonoscopy. Laparoscopic near-total gastrectomy with D1+ lymph node dissection and left hemicolectomy were performed sequentially without significant events. The patient was discharged without any postoperative complications. Conclusions We reported a rare case of EGC with multiple gastric GISTs combined with synchronous colon cancer.

scholarly journals Robotic gastric resection of large gastrointestinal stromal tumors

2013 ◽  
Vol 11 (2) ◽  
pp. 191-196 ◽  
Author(s):  
Jacopo Desiderio ◽  
Stefano Trastulli ◽  
Roberto Cirocchi ◽  
Carlo Boselli ◽  
Giuseppe Noya ◽  
...  
Keyword(s):  
Gastrointestinal Stromal Tumors ◽  
Gastric Resection ◽  
Stromal Tumors

Laparoscopic gastric resection for gastrointestinal stromal tumors

2008 ◽  
Vol 22 (12) ◽  
pp. 2583-2587 ◽  
Author(s):  
Jennifer A. Sexton ◽  
Richard A. Pierce ◽  
Valerie J. Halpin ◽  
J. Christopher Eagon ◽  
William G. Hawkins ◽  
...  
Keyword(s):  
Gastrointestinal Stromal Tumors ◽  
Gastric Resection ◽  
Stromal Tumors ◽  
Laparoscopic Gastric Resection
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