Objective: To evaluate the feasibility and safety of curved cutter stapler in laparoscopic curve resection for gastric gastrointestinal stromal tumor(GIST).
Methods: A retrospective clinical study was carried out with the clinical data of 19 cases of gastric GIST, who received laparoscopic curve resection with the curved cutter stapler during the period between January 2015 and December 2015 in Department of General Surgery, Beijing Chaoyang Hospital, Capital Medical University. Curved cutter stapler was used intraoperatively to run curve resection for stomach, at least 0.5 cm away from the tumor outer margin. If the curved cutter stapler could not completely cut off the gastric wall at first time, the linear cutter stapler would be used secondly to cut off the remaining gastric wall.
Results: All the cases were successfully performed under laparoscopy, without conversion to open surgery and the occurrence of severe complications. Fourteen(73.7%) patients received complete transection by the first curved cutter stapler, the other 5(26.3%) cases accepted complete transection by the second linear cutter stapler. The operative time ranged from 50 to 100(71.8±12.7) minutes, the blood loss ranged from 20 to 50 (33.6±7.4) ml, the postoperative exhaust time ranged from 1 to 4 (2.4±0.9) days, the postoperative hospital stay ranged from 5 to 9(6.8±1.1) days. There was no patient suffered from incision infection, delayed gastric emptying, anastomotic leakage and anastomotic bleeding. The postoperative pathological examination confirmed that all the cases were GIST. The tumor length ranged from 1.5 to 5.5(2.9±1.1) cm, the resection margin ranged from 0.5 to 2.0(1.2±0.4) cm and all the patients had negative resection margins. Of the 19 cases, 8(42.1%) were classified as very low risk, 5(26.3%) as low risk, 5(26.3%) as moderate risk and 1(5.3%) as high risk according to the National Institute of Health classification. Six patients with moderate and high risk were treated with imatinib. In the follow-up time of 5 to 16 months(mean 10 months) after operation, no distant metastasis and local recurrence occurred in all the cases.
Conclusion: The application of curved cutter stapler in laparoscopic curve resection for GIST is safe and feasible with good short-term efficacy.