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Minimally Invasive Treatment of Gastric GIST

  • Carlos Moreno-SanzEmail author
  • Miguel A. Cuesta
Chapter

Abstract

Gastrointestinal stromal tumours (GIST) form 5% of all gastrointestinal tumours and 40–60% of these are located in the stomach. GIST derive from the interstitial cells of Cajal [1] and constitute a separate entity from leiomyoma and leiomyosarcoma, which were previously thought to be the most common soft-tissue neoplasms in the gastrointestinal tract. Gastrointestinal stromal tumours are classified by molecular and immunohistological features and are characterized by overexpression of the tyrosine kinase receptor KIT. The criteria for differentiating benign from malignant gastric GISTs have been debated for several years. Tumour size and mitotic index, but not microscopic margins of resection, have been shown to be significant factors for predicting survival. Gastric GISTs that are smaller than 5 cm and have fewer than 5 mitoses per high-power field are considered to have low malignant potential. Tumours measuring 5–10 cm or having 5–10 mitoses per high-power field are considered intermediate risk, and those measuring greater than 10 cm or having more than 10 mitoses per high-power field are considering high risk [2]. Location and staging have been performed by a combination of endoscopy with detailed information about the exact location and size of the tumour, endoscopic ultrasonography and CT-scan.

Keywords

Laparoscopy GIST Gastric resection Wedge resection 

Supplementary material

Video 18.1

Laparoscopic transgastric resection of a GIST (MP4 984788 kb)

Video 18.2

Laparoscopic central gastrectomy because of a GIST (MP4 727321 kb)

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Copyright information

© Springer International Publishing AG 2017

Authors and Affiliations

  1. 1.Department of General and Digestive SurgeryHospital General La Mancha CentroCiudad RealSpain
  2. 2.VUmcAmsterdamThe Netherlands

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