| Theme | GIST (gastrointestinal stromal tumor) | |
|---|---|---|
| Title | Surgical Treatment of GIST | |
| Publish Date | 2005/08 | |
| Author | Tetsu Fukunaga | Department of Gastroenterological Surgery, The Cancer Institute Ariake Hospital, Japan Foundation for Cancer Research |
| Author | Naoki Hiki | Department of Gastroenterological Surgery, The Cancer Institute Ariake Hospital, Japan Foundation for Cancer Research |
| Author | Yasuyuki Seto | Department of Gastroenterological Surgery, The Cancer Institute Ariake Hospital, Japan Foundation for Cancer Research |
| Author | Shigekazu Oyama | Department of Gastroenterological Surgery, The Cancer Institute Ariake Hospital, Japan Foundation for Cancer Research |
| Author | Toshiharu Yamaguchi | Department of Gastroenterological Surgery, The Cancer Institute Ariake Hospital, Japan Foundation for Cancer Research |
| [ Summary ] | GIST (gastrointestinal stromal tumor) are mesenchymal tumors of the gastrointestinal tract which have recently been established as a distinct disease entity which has attracted attention in the medical community. Guidelines for treatment are used in Western countries, but they cannot be adopted without modification in Japan. Clinically, GIST resembles tumors formerly diagnosed as leiomyosarcoma by pathological examination with HE staining and treated as such. Based on the results of leiomyosarcoma treatment in the past, the treatment of first choice is currently surgical procedures aimed at complete resection of the tumor. Since it is a clinical characteristic of GIST that the results of systematic lymph node dissection are unclear, local resection of the stomach without lymphadenectomy is commonly performed. At our department, tumors 5 cm or less in diameter are treated by laparoscopic wedge resection of the stomach. With this as the basic procedure, if the tumor is located near the cardia or pylorus and if wedge resection causes deformation, laparoscopy-assisted gastrectomy is conducted. There has been no post laparoscopic surgery recurrence, and results have been good. However, tumors of 5 cm or more in diameter are treated with open gastrectomy aimed at complete resection with careful attention not to rupture the tumor or cause infiltration of adjacent tissues. |
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