Laparoscopic Limited Resection for Duodenal Gastrointestinal Stromal Tumors
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MULTIMEDIA ARTICLE
Laparoscopic Limited Resection for Duodenal Gastrointestinal Stromal Tumors Toshiyasu Ojima 1 & Masaki Nakamura 1 & Keiji Hayata 1 & Junya Kitadani 1 & Masahiro Katsuda 1 & Akihiro Takeuchi 1 & Shinta Tominaga 1 & Hiroki Yamaue 1 Received: 13 May 2020 / Accepted: 4 June 2020 # 2020 The Society for Surgery of the Alimentary Tract
Abstract Background Laparoscopic surgery may be a suitable treatment for gastrointestinal stromal tumors (GISTs) in terms of oncological feasibility and being minimally invasive. Case series of laparoscopic resection for duodenal GISTs have not been reported in detail, so in this report, the detail of laparoscopic surgeries for duodenal GISTs is summarized. Methods This is a single-center retrospective case series of six consecutive patients with duodenal GISTs who underwent laparoscopic limited resection of the duodenum between 2003 and 2019. Results Tumors were located within the first portion in three patients, the second portion in two patients, and the third portion in one patient. Median tumor size was 25 mm. Four patients underwent a laparoscopic and endoscopic fullthickness resection with primary closure, one patient underwent a laparoscopic wedge resection, and one patient underwent a laparoscopic segmental duodenectomy with Roux-en-Y gastrojejunostomy. Median blood loss was minimal (10 ml) with median operative time of 2 h, and there were no conversions to open surgery. There were no intraoperative or postoperative complications. All patients underwent curative resection with negative surgical margins, and none had recurrence of their duodenal GISTs. All patients were alive at the end of the follow-up period of 54 months. Conclusion Laparoscopic limited resection is a feasible, safe, and ideal treatment procedure for duodenal GISTs in terms of shortand long-term surgical outcomes. Keywords Duodenal gastrointestinal stromal tumors . Laparoscopic surgery . Laparoscopic and endoscopic cooperative surgery . Minimally invasive surgery . Single incisional laparoscopic surgery
Introduction Gastrointestinal stromal tumors (GISTs) can arise anywhere in the digestive tract, but the stomach is the most common site (50–60%), followed by the small intestine (20–30%) and, rarely, the colo-rectum (10%).1,2 Duodenal GISTs are very rare and represent only about 5% of all GISTs.3 The primary Electronic supplementary material The online version of this article (https://doi.org/10.1007/s11605-020-04692-6) contains supplementary material, which is available to authorized users. * Toshiyasu Ojima [email protected] 1
Second Department of Surgery, Wakayama Medical University, Wakayama, Japan
curative approach to treat GISTs is surgical resection with a negative margin. Additional lymphadenectomy is not required, so surgery for GISTs is a relatively simple procedure. Laparoscopic surgery may therefore be suitable for the treatment of GISTs in terms of oncological feasibility and being minimally invasive. Several papers have previously reported the use of laparoscopic surger
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