Abstract:
Objective:To investigate the efficacy of laparoscopic and gastroscopic resection on gastric stromal tumors. Methods:The clinicopathologic data of 30 cases ( 18 males and 12 females) of gastric stromal tumors treated with laparoscopy combined with gastroscopy between July 2004 and March 2009 were retrospectively analyzed. Results: The preoperative diagnosis of gastric stromal tumors mainly relied on gastroscopy ,ultrasound gastroscopy ,barium meal, abdominal CT scan and abdominal MRI. Tumors were located in the posterior wall of the stomach in 11 cases, in the gastric anterior wall in 19cases, in the lower portion of the stomach in 10cases, in the gastric body in 16cases (in the greater curvature side in 11cases and in the lesser curvature in 5 cases), in the small bend of the gastric cardia in 1 case, and in the gastric body at the junction in 3 cases. All surgeries were successfully accomplished, with no death or conversion to laparotomy. The surgical duration was 40-120 min (70min on average), with a blood loss of20mL to80mL. Tumor size ranged from 0.7 cm to 5 cm (1.5 cm on average). Postoperative immunohistochemistry showed positive expression of CD 117 in 28cases (96.6%) and positive expression of CD34in 26cases (86.6%). As to tumor-biological risk, 18cases had very low degree risk, 9 cases had low degree risk, and 3 cases had moderate degree risk. No cases had high degree risk. Within 48h after surgery, patients could get out of bed and gastrointestinal function was restored. Patients had liquid diet at 2-3 days after surgery. No postoperative complications were observed. Postoperative hospital stay was 4-10days. No recurrence or metabasis occurred in all of 30cases during the follow up (1~36months). Conclusion:Clinical manifestation of gastric stromal tumor lacks specificity and its diagnosis relies mainly on upper gastrointestinal imaging, video endoscopy, ultrasound endoscopy, and CT scan. The only effective treatment for gastric stromal tumors is surgical resection. Resection of gastric stromal tumors with laparoscopy combined with gastroscopy is a safe and effective treatment for gastric stromal tumor, with satisfactory positioning accuracy, fewer complications, less trauma, and faster postoperative recovery.