Minimally invasive surgery for posterior gastric stromal tumors

Background: Because involvement is extremely rare, surgery for gastric stro mal tumors consists of local excision with clear resection margins. The aim of this study was to report the results of a consecutive series of nine pa tients with posterior gastric stromal tumors that were excised using a mini mally invasive method. Methods: Patients received a general anesthetic before placement of three l aparoscopic ports- a 10-mm (umbilical) port for the telescope and two worki ng ports, a 12-mm port (left upper quadrant) and a IO-mm port (right upper quadrant). Grasping forceps were placed through an anteriorly placed gastro tomy to deliver the tumor through the gastrotomy into the abdominal cavity, thus allowing an endoscopic linear cutter to excise the tumor with a cuff of normal gastric tissue. Results: Nine consecutive patients with a median age of 73 years (range, 47 -83) were treated. In seven patients, laparoscopic removal of the tumor was achieved. Two patients required conversion to an open operation because th e tumor could not be delivered into the abdominal cavity. The median length of postoperative stay for the seven patients in whom the procedure was com pleted laparoscopically was 3 days (range, 2-6). Conclusions: Posterior gastric stromal tumors can be removed safely using t his minimally invasive method. Delivery of the tumor through the gastrotomy is essential for success.