Totally Laparoscopic Transluminal Resection for Gastrointestinal Stromal Tumors Located at the Cardiac Region.

BACKGROUND: The most common laparoscopic surgery for gastric gastrointestinal stromal tumors (GISTs) currently includes laparoscopic wedge resection, laparoscopic transgastric surgery, and laparoscopic intragastic surgery [Ohashi in Surg Endosc 9:169-171, 1995].

METHODS: The clinical data of 10 cases of cardiac endophytic GIST patients who received total laparoscopic intragastric surgery from June 2014 to March 2016 in Guangdong General Hospital were retrospectively analyzed.

RESULTS: All cases were operated successfully without conversion to laparotomy. Operative time ranged from 59 to 104 min and blood loss was 5-65 mL. All specimens had intact capsules, diameters ranged from 16 to 26 mm, circumferential resection margins were 9-15 mm, and basement resection margins were 4-8 mm. All cases were pathologically diagnosed with GISTs. Time of flatus ranged from 1 to 4 days, time to resume eating was 2-4 days, drainage removal time was 3-4 days, and discharge time was 4-6 days. There was no postoperative hemorrhage, anastomotic leakage, cardiac stenosis, or other complications. All patients showed no swallowing disorders or acid reflux, and there were no signs of recurrence or metastasis in the follow-up period.

CONCLUSION: Total laparoscopic intragastric treatment for cardiac endophytic GISTs is safe and feasible; however, an advanced laparoscopic surgical technique is required, which needs to be performed with caution.