Short-Term and Long-Term Outcomes of Laparoscopic Local Resection of the Stomach Using the "Lift-And-Cut Method" for Gastric Gastrointestinal Stromal Tumors.

INTRODUCTION

In laparoscopic local resection of the stomach for gastric gastrointestinal stromal tumors (GISTs), wedge resection and laparoscopic and endoscopic cooperative surgery (LECS) are commonly employed. However, wedge resection can result in excessive removal of gastric tissue, leading to postoperative deformity, while LECS carries risks such as surgical site infection, intra-abdominal abscess, and potential tumor cell seeding due to gastric lumen opening. To overcome these limitations, we developed the "lift-and-cut method," a minimally invasive surgery (MIS) designed to minimize gastric resection without opening the gastric lumen. This study reports the short- and long-term outcomes of patients treated with this approach.

METHODS

We retrospectively reviewed consecutive cases of gastric GIST treated with the "lift-and-cut method" between June 2011 and May 2024.

RESULTS

A total of 80 patients underwent the "lift-and-cut method". The median operative time was 107 min (interquartile range [IQR], 77-141 min), with no intraoperative blood loss (IQR, 0-0 g). The median postoperative hospital stay was 7 days (IQR, 6-8 days). One patient experienced a postoperative urinary tract infection. According to the modified Fletcher classification, tumor risk levels were very low (n = 9), low (n = 49), intermediate (n = 14), and high (n = 8). After a median follow-up of 60.0 months (IQR, 24.0-89.3 months), one patient died of recurrence, and another from an unrelated cause.

CONCLUSION

The "lift-and-cut method" appears to be a safe and effective minimally invasive option for gastric GIST, offering favorable short- and long-term outcomes while minimizing tissue resection and avoiding gastric lumen entry.