Laparoscopic resection for gastric neuroendocrine and stromal tumors: a single- center prospective study

In stomach, the majority of the endocrine system neoplasm is situated in the corpus or the fundus, constituting a collection of non-functioning, enterochromaffin similar cell, and proper differentiated carcinoid. The golden standard in gastric GIST and NET is always operational removal whenever possible. In this study, we aimed to exhibit our outcomes by experience on laparoscopic resection of GIST and NETs, each one in the stomach. The current study was prospectively designed in our hospital to assess the likelihood and the safeness of the laparoscopy for individuals with GISTs and NETs, between January 2012 and 2014. Partial gastric resection was applied to eleven individuals (6 males /5 females) who were clinically determined as stomach-located GIST and NETs. The mean value of the tumor diameter was 4.2±1,36 cm (range: 2.5-6.8, median:4.3 cm). Tumor locations were around the fundus (n:2;%18.1), the antrum (n:3;%27.3), and the corpus (n:6; %54.5). The mitotic counts of the tumors were found to be 10/50 HPF in 2 patients. All 7 GISTs were c-KIT (CD117), DOG1 or CD34 positive (n:7). All 4 NETs were both Synaptophysin and Chromogranin positive. The main presenting symptom was abdominal pain (n:6, %54). In this article, the results supported that the laparoscopic way on the treatment of gastric GISTs and NETs is a secure and profitable selection for individuals if treated properly

PDF

___

1. Nabeshima K, Tomioku M, Nakamura K, Yasuda S. Combination of Laparoscopic and Endoscopic Approaches to Neoplasia with Nonexposure Technique (CLEAN-NET) for GIST with Ulceration. Tokai J Exp Clin Med. 2015;40(3):115-9.

2. Kim SW, Kim HC, Yang DM and Won KY. Gastrointestinal stromal tumours (GISTs) with a thousand faces: atypical manifestations and causes of misdiagnosis on imaging. Clin Radiol. 2016;71(2):130-42.

3. Miettinen M, Paal E, Lasota J, Sobin LH. Gastrointestinal glomus tumors: a clinicopathologic, immunohistochemical, and molecular genetic study of 32 cases. Am J Surg Pathol. 2002;26(3):301-1.

4. Horenstein MG, Hitchcock TA, Tucker JA. Dual CD117 expression in gastrointestinal stromal tumor (GIST) and paraganglioma of Carney triad: a case report. Int J Surg Pathol. 2005;13(1):87-92.

5. Chung JC, Chu CW, Cho GS, Shin EJ, Lim CW, Kim HC Song OP. Management and outcome of gastrointestinal stromal tumors of the duodenum. J Gastrointest Surg. 2010;14(5):880-3.

6. Demetri GD, von Mehren M, Antonescu CR, DeMatteo RP, Ganjoo KN, Maki RG, Pisters PW, Raut CP, Riedel RF, Schuetze S, Sundar HM, Trent JC, Wayne JD. NCCN Task Force Report: Update on the Management of Patients with Gastrointestinal Stromal Tumors. Journal of the National Comprehensive Cancer Network:JNCCN 2010;8:1-44.

7. Nishida T, Blay JY, Hirota S, Kitagawa Y, Kang YK. The standard diagnosis, treatment, and follow-up of gastrointestinal stromal tumors based on guidelines. Gastric Cancer. 2016;19(1):3-14.

8. Ye Y, Gao Z, Wang S. Surgical principles of gastrointestinal stromal tumors at different locations. Zhonghua Wei Chang Wai Ke Za Zhi. 2015;18(4):301-4.

9. Sarsu SB, Karapur A. Ileal Perforation Caused by Typhoid Fever. Ulutas Med J. 2015;1:86-9.

10. Cao F, Li ANG, Li JIA, Fang YU, Li FEI. Feasibility and safety of laparoscopic resection for gastric GISTs larger than 5 cm: Results from a prospective study. Oncol Lett. 2015;10(4):2081-6.

11. Sarici IS, Kala F, Kara G, Eskut N, Gündogdu E. Gastrocolocutaneous Fistula-Delayed complication of Percutaneous Endoscopic Gastrostomy, Case report. Ulutas Med J. 2015;1:116-8.

12. Partelli S, Maurizi A, Baldoni A, Polenta V, Crippa S, Falconi M. GEP-NETS update: a review on surgery of gastro-entero-pancreatic neuroendocrine tumors. Eur J Endocrinol. 2014;171:153-62.

13. de Herder WW. Gastroenteropancreatic neuroendocrine tumors (GEP-NETs). Best Pract Res Clin Gastroenterol. 2012; 26(6): 689-90.

14. Hoteya S, Haruta S, Shinohara H, Yamada A, Furuhata T, Yamashita S, Kikuchi D, Mitani T, Ogawa O, Matsui A, Iizuka T,Udagawa H, Kaise M. Feasibility and safety of laparoscopic and endoscopic cooperative surgery for gastric submucosal tumors, including esophagogastric junction tumors. Dig Endosc. 2013;26:538-44.

15. Qiu WQ, Zhuang J, Wang M, Liu H, Shen ZY, Xue HB, Shen L, Ge ZZ, Cao H. Minimally invasive treatment of laparoscopic and endoscopic cooperative surgery for patients with gastric gastrointestinal stromal tumors. J Dig Dis. 2013;14(9):469-73.

16. Tsujimoto H, Yaguchi Y, Kumano I, Takahata R, Ono S, Hase K. Successful Gastric Submucosal Tumor Resection Using Laparoscopic and Endoscopic Cooperative Surgery. World J Surg. 2011;36(2):327- 30.

17. Kawahira H, Hayashi H, Natsume T, Akai T, Uesato M, Horibe D, Mori M, Hanari N, Aoyama H, Nabeya Y, Shuto K,Matsubara H. Surgical Advantages of Gastric SMTs by Laparoscopy and Endoscopy Cooperative Surgery. Hepatogastroenterology. 2012;59(114):1-5.

18. Hiki N, Yamamoto Y, Fukunaga T, Yamaguchi T, Nunobe S, Tokunaga M, Miki A, Ohyama S, Seto Y. Laparoscopic and endoscopic cooperative surgery for gastrointestinal stromal tumor dissection. Surg Endosc. 2007;22(7):1729-35.

19. De Vogelaere K, Van Loo I, Peters O, Hoorens A, Haentjens P, Delvaux G. Laparoscopic resection of gastric gastrointestinal stromal tumors (GIST) is safe and effective, irrespective of tumor size. Surg Endosc. 2012;26(8):2339-45.

20. Ronellenfitsch U, Staiger W, Kähler G, Ströbel P, Schwarzbach M, Hohenberger P. Perioperative and Oncological Outcome of Laparoscopic Resection of Gastrointestinal Stromal Tumour (GIST) of the Stomach. Diagn Ther Endos. 2009;2009:286138

21. Novitsky YW, Kercher KW, Sing RF, Heniford BT. Long-term Outcomes of Laparoscopic Resection of Gastric Gastrointestinal Stromal Tumors. Ann Surg. 2006;243(6):738-47.

22. Lukaszczyk JJ, Preletz RJ. Laparoscopic Resection of Benign Stromal Tumor of the Stomach. J Laparoendos Surg. 1992;2(6):331- 4.

23. Nguyen SQ, Divino CM, Wang JL, Dikman SH. Laparoscopic management of gastrointestinal stromal tumors. Surg Endosc. 2006;20(5):713-6.