Laparo-endoscopic transgastric resection of gastric gastrointestinal stromal tumor located near the gastro-oesophageal junction with hiatus hernia repair

Abstract

A 63-year-old male presented to us with upper abdominal pain and odynophagia for 3 months. Contrast-enhanced computed tomography of the abdomen revealed hiatus hernia with ulceroproliferative growth involving the gastro-oesophageal (GE) junction and cardia of the stomach with no obvious transserosal extension. Upper gastrointestinal (GI) endoscopy was suggestive of a tumour of size 3 cm × 3 cm near the GE junction and sliding hiatus hernia. Although there are various ways described in the literature for managing GI stromal tumour (GIST), we opted for laparo-endoscopic transgastric resection with hiatus hernia repair due to obvious advantages in terms of safety and efficacy. Just a handful of cases have been described in the literature being treated in this fashion. The procedure was successfully performed as evidenced by an uneventful recovery of the patient. His histopathology report was suggestive of GIST of size 3.5 cm × 3.0 cm × 2.0 cm. The resected margins were free of the tumour.

Keywords

• gastro-oesophageal junction
• gastrointestinal stromal tumours
• hiatus hernia
• laparo-endoscopy
• transgastric