Evaluation of Wedge Resection Gastrointestinal Stromal Tumor [GIST] of the Stomach

Document Type : Original Article

Authors

1 Department of Surgical Oncology, Faculty of Medicine, Al-Azhar University, Cairo, Egypt

2 Department of Surgical Oncology, National Cancer Institute, Cairo University, Giza, Egypt

3 Department of General Surgery, Faculty of Medicine, Al-Azhar University, Cairo, Egypt.

Abstract

Background: A gastrointestinal stromal tumor [GIST] is the most common mesenchymal tumor affecting the gastrointestinal tract with the stomach is the commonest site. Many treatment options are available aiming to prevent recurrence and metastasis.
Aim of the work: This study aimed to evaluate the oncological safety and survival rate after wedge resection of gastric GIST.  
Patients and Methods: This was a retrospective study of patients with Gastric GIST who underwent wedge resection. The patient evaluation was performed in a systematic manner. Firstly, full history taking, followed by general and local [Abdominal] examinations. Results of laboratory investigations were collected. The radiological investigations included the results of ultrasound or computed tomography- guided tru-cut biopsy of the gastric mass. Early detection of recurrence was facilitated by follow-up imaging with contrast-enhanced CT scans of the abdomen every six months for five years. This follow-up protocol enabled vigilant monitoring of patients and was essential for assessing the overall outcomes.
Results: The study included 36 patients, their age ranged from 29 to 70 years with mean of 54.7±12.6 years, and 22 [61.1%] were females. Of our cases, 20 [55.6%] underwent sleeve gastrectomy, and 16 [44.4%] underwent partial gastrectomy/wide local excision. The mitotic index was <5/50 in 16 [44.4%] patients and was >5/50 in 20 [55.6%] patients. The primary closure was the most common method of reconstruction used in 34 [94.4%]. Only 6 [16.7%] patients had postoperative complication; 2 [5%] had chest infection, 2 [5%] had incisional hernia, and 2 [5%] developed postoperative leakage. The median follow-up time of the studied patients was 45.5 months. The loco-regional recurrence occurred in 2 [5.6%] patients, 2 [5.6%] patients showed distant metastasis and 1 [2.7%] patient had died.
Conclusion: Wedge resection is an efficient and safe procedure in patients with gastric GIST as it showed high overall survival rate and low rate of recurrence and postoperative complications.

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