In a study published in Surgery Today, researchers looked into the safety of performing local resection of gastrointestinal stromal tumors (GISTs) near the esophagogastric junction (EGJ) and found that the procedure could be done safely with a low risk of recurrence and only a few postoperative complications.
GISTs are cancers that can arise at any part of the gastrointestinal tract. GISTs that are located near the EGJ are of particular interest because laparoscopic local resection to remove them increases the risk of injuring the EGJ, thus leading to poorer outcomes.
Read more about GIST diagnosis
This study is a retrospective analysis of 40 patients who had laparoscopic local resection for GISTs that were located near the EGJ between a period of 11 years, from January 2009 to December 2019. One patient was excluded because the patient had also undergone a right colectomy during surgery. The remaining 39 patients were classified according to the distance of the GIST edge to the EGJ. If the distance of the GIST edge to the EGJ was 0 to 2.0 cm, the patients were put in the near group (n=16); if the distance was 2.1 to 5.0 cm, they were placed in the far group (n=23).
Four indicators of outcomes were measured: operation time, blood loss, time of postoperative stay, and postoperative complication rate. There were no differences in any of the parameters between the groups. Only one of the 39 patients experienced anastomotic leakage, and it was noted that this patient’s GIST was located on the EGJ itself. Tumor recurrence occurred in 3 patients from the near group, with all the tumors recurring on the EGJ.
This study shows that laparoscopic resection of GISTs near the EGJ measuring 0 cm to 5.0 cm is safe, except when the GIST is located on the EGJ itself.
Tanigawa K, Kanaji S, Sawada R, et al. Safety of laparoscopic local resection for gastrointestinal stromal tumors near the esophagogastric junction. Surg Today. Published July 19, 2021. doi:10.1007/s00595-021-02345-y