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1Laparoscopicmanagementofgastricgastrointestinalstromaltumors显示文摘Gastrointestinal stromal tumors (GISTs) are the most frequent gastrointestinal tumors of mesodermal origin. Gastric GISTs represent approximately 70% of all gas-trointestinal GISTs. The only curative option is surgical resection. Many surgical groups have shown good results with the laparoscopic approach. There have not been any randomized controlled trials comparing the open vs laparoscopic approach, and all recommenda-tions have been based on observational studies. The experience obtained from gastric laparoscopic surgery during recent decades and the development of specific devices have allowed the treatment of most gastric GISTs through the laparoscopic approach.Correa-Cote J Morales-Uribe C Sanabria A 2014World Journal of Gastrointestinal Endoscopy2014,6,7:7
2Tumor rupture during surgery for gastrointestinal stromal tumors: Pay attention!显示文摘In a recently published letter to the editor, we debated the proposal by Coccolini et al to treat gastrointestinal stromal tumors (GISTs) of the esophagogastric junction with enucleation and, if indicated, adjuvant therapy. We highlighted that, because the prognostic impact of a T1 high-mitotic rate esophageal GIST is worse than that of a T1 high-mitotic rate gastric GIST, enucleation may not be adequate surgery for esophagogastric GISTs with a high mitotic rate. In rebuttal, Coccolini et al pointed out the possible bias in assessment of the mitotic rates due to the lack of standardized methods and underlined that the site and features of the tumor need to be carefully considered in evaluation of the risk-benefit balance. Here we confirm that, apart from the problematic issue of mitotic counting, enucleation should not be indicated for GISTs at any site to reduce the risk of tumor rupture, which has been recently considered to be an unfavorable prognostic factor, and to avoid microscopic residual tumor.Nadia Peparini Piero Chirletti 2013World Journal of Gastroenterology2013,19,12:3
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