Gastrointestinal mesenchymal stromal tumor (GIST), for which surgery is currently recommended, is not recommended for minimally invasive endoscopic resection.
There is a lack of comparative studies on the medium- and long-term safety of endoscopic resection of GIST, so it is not routinely recommended. Furthermore, the boundaries between most GIST tumors and the surrounding muscular tissues are not well defined, making radical endoscopic resection not easy and with a high incidence of operative complications (mainly hemorrhage, perforation, and tumor cell implantation).
Open surgery is still the most common surgical method for GIST. Segmental or wedge resection is the most commonly used method of local excision. For cases involving recurrent surgery or organ function preservation, a multidisciplinary expert panel discussion is recommended to decide whether or not to perform preoperative imatinib therapy.
In experienced medical centers, laparoscopic resection may be considered depending on tumor site and size. If the GIST tumor requires a large abdominal incision for complete removal, laparoscopic surgery is not recommended. Tumor rupture and dissemination should also be avoided intraoperatively.
It is recommended to standardize the treatment under doctor’s evaluation.