Laparoscopic Gastric Wedge Resection for a GIST
Vahagn G. Hambardzumyan, MD1; Martin Goodman, MD2
1Yerevan State Medical University, Heratsi Hospital Complex
2Tufts University School of Medicine
The stomach is involved in multiple common ailments, including gastroesophageal reflux disease, gastric ulcers, and cancer, the latter of which can take many forms. Originally, GISTs arise from the connective tissue, or stroma, of the stomach, rather than the lining, from which the more common and more deadly gastric adenocarcinoma finds its origin. However, over time, study revealed that GIST arises from a very specific cell, called the interstitial cells of Cajal, that are responsible for the timing of contraction in the stomach and small intestine. GIST masses generally behave more indolently than gastric adenocarcinoma, with distant or lymph node metastases a rare feature, although involvement of the liver and peritoneum has been described. Due to this indolent nature, certain masses, once they have been identified as GIST through endoscopic biopsy, are candidates for surveillance. However, larger masses (as identified through evidence of necrosis on imaging) and rapidly growing masses are treated primarily with surgical resection. While in the past surgical resection would have involved a large abdominal incision and a lengthy postoperative recovery, laparoscopic techniques have allowed gastric resection to become a short procedure necessitating only an overnight stay.
