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A Journal on Surgery

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Chirurgia 2004 April;17(2):39-42

language: English

Complicated gastrointestinal stromal tumors. Management implications during urgency or emergency surgery

Caratozzolo E., Massani M., Recordare A., Bonariol L., Callegari F., Antoniutti M., Padoan L., Callegari P., Jelmoni A., Bassi N.


Aim. Gastrointestinal stromal tumors (GISTs) are rare tumors of the digestive tract. They usually present aspecific symptoms, though acute onset is possible with massive digestive bleeding, bowel obstruction or peritonitis. Management implications during urgency or emergency surgery are reported.
Methods. The present study includes patients treated for GISTs complication and aims at evaluating the influence of various clinico-pathologic factors on disease-free survival as well as verifying the usefulness of an aggressive approach during emergency surgery.
Results. Two patients with uncontrollable gastric bleeding, and 1 patient with peritonitis due to a GISTs perforation, underwent emergency laparotomy. Seven patients needed urgent laparotomy. Gastroresection for middle or distal gastric third localization GISTs and gastrectomy for cardial located or large size GISTs were carried out. Jejeunal and ileal GISTs were completely resected. The gastric tumor average size was 5.5 cm while small bowel average size was 4 cm. Patients underwent emergency laparotomy showed significantly large tumors with a high number of mitosis (p=0.025). The actuarial 12-months survival rate is 8/10 patients.
Conclusion. The results reached on the cohort of patients seem to support a relation between the diameter of GISTs and the number of mitosis for high power field (HPT). In our experience gross resection of GISTs in the stomach as well as in the small bowel, had good short- and long-term results.

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