Friday, July 17, 2009
Laparoscopic Gastric GIST resection
This patient, during a routine EGD for epigastric discomfort, was found to have a small submucosal mass in the gastric antrum (you can see it on the above CT if you look closely). A subsequent endoscopic ultrasound suggested that there was some invasion of the muscle layer of the stomach as well. The surgery went well. A combination of endoscopic staplers and laparoscopic suturing closed the resultant gastrotomy. The patient went home on day #3. The final path confirmed a low grade GIST (gastrointestinal stromal tumor) with clean margins.
Laparoscopy for gastric stromal tumors is a reasonable alternative to the traditional open approach. Here's a link to a paper by some smart guys down in North Carolina on the topic. Best outcomes are seen when the tumor is small, has a low mitotic index (i.e. rate of growth), and when the surgical margins are clean. Check, check and check on my guy. He ought to do just fine.