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Single-incision transgastric resection for gastric gastrointestinal stromal tumors in anatomically challenging locations

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Abstract

Surgical resection is the mainstay treatment for resectable gastrointestinal stromal tumors (GISTs). However, resection in anatomically challenging locations, such as near the gastroesophageal junction, lesser curve and fundus, remain technically challenging. We herein report the outcomes of the largest series of patients who underwent single-incision transgastric resection of an intraluminal gastric GIST. Our reduced-port resection technique for intraluminal GISTs in these anatomically challenging locations involves a single incision in the left hypochondrium, deepened to access the gastric lumen, with the surgery completed in a transgastric manner. A total of 22 patients received surgery with this technique at the National University Hospital in Singapore from November 2012 to September 2020. The median operative time was 101 (range 50–253) min, with no conversions to open surgery, median lesion size 3.6 (range 1.8–8.2) cm and median postoperative length of stay 5 (range 1–13) days. There was no 30-day mortality and no recurrence during the follow-up period. Our laparoscopic approach for reduced-port transgastric excision of intraluminal GISTs allows for adequate surgical clearance, convenient extraction and secure gastrostomy closure with low morbidity.

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Fig. 1
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Data availability

All data generated or analyzed during this study are included in this article. Further enquiries can be directed to the corresponding author.

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Acknowledgements

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Funding

No funding was received for this study.

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Author notes

  1. Jia Hao Law and Nicole Xinrong Han have contributed equally to this work

Authors and Affiliations

  1. Division of Upper Gastrointestinal Surgery, Department of Surgery, National University Health System, Singapore, Singapore

    Jia Hao Law, Jimmy Bok Yan So, Guowei Kim & Asim Shabbir

  2. Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore

    Nicole Xinrong Han

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  1. Jia Hao Law
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Contributions

NXH was involved in the conception of the study, data collection, data analysis, as well as manuscript writing. JHL was involved in the conception of the study, data collection, data analysis, as well as manuscript writing. JBYS was involved in the conception of the study, data analysis, as well as manuscript writing. GK was involved in the conception of the study, data analysis, as well as manuscript writing. AS was involved in the conception of the study, data analysis, as well as manuscript writing.

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Correspondence to Asim Shabbir.

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Conflict of interest

Nicole Xinrong Han, Jia Hao Law, Jimmy Bok Yan So, Guowei Kim and Asim Shabbir have no conflict of interest.

Statement of ethics

National Healthcare Group Domain Specific Review Board (NHG DSRB) Approval under DSRB Domain B (Reference number: 2020/01266) was sought and obtained. The need for written consent was waived.

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Law, J.H., Han, N.X., So, J.B.Y. et al. Single-incision transgastric resection for gastric gastrointestinal stromal tumors in anatomically challenging locations. Surg Today 53, 1401–1408 (2023). https://doi.org/10.1007/s00595-023-02694-w

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  • DOI: https://doi.org/10.1007/s00595-023-02694-w

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