1. „Rendezvous-Guided“ Minimal-Invasive Resection of Gastric Stroma Tumor
P. Lingohr, A. Plamper,
K. P. Rheinwalt, E. Kleimann
Department of Surgery
St. Franziskus Hospital, Cologne, Germany
13. International Congress of the EAES

2. „Gastrointestinal stroma tumor“ (GIST)
Dr. med. P. Lingohr St. Franziskus Hospital, Cologne
„Gastrointestinal stroma tumor“ (GIST)
Incidence: • 2-3/100000/year
Localisation: • 30 – 60 % in the stomach
• 30 % in the small intestine
Symptoms: • 80 % asymptomatic
• symptomatic
 60 % chronical bleeding
• seldomly acute bleeding
Ludwig et al. 1997, Mietinen et al. 1998, Deniatteo et al. 2000,
Demetri et al. 2002, Mietinen et al. 2002, Rossi et al. 2003

3. Case report: 76 year old woman
Dr. med. P. Lingohr St. Franziskus Hospital, Cologne
Case report:
76 year old woman
• Hematemesis and acute circulatory problems
 emergency endoscopy  no acute bleeding, but tumor in
the gastric corpus fundus region
 PE
 Histologie: GIST

4.  Preoperative staging  no metastases
Dr. med. P. Lingohr St. Franziskus Hospital, Cologne
Case report:
 Preoperative staging  no metastases
 Operation

5. Dr. med. P. Lingohr St. Franziskus Hospital, Cologne

6. Final results: Histologie: • Gastrointestinal stroma tumor (GIST)
Dr. med. P. Lingohr St. Franziskus Hospital, Cologne
Final results:
Histologie: • Gastrointestinal stroma tumor (GIST)
• Tumour size: 2,5 x 2,7 x 1 cm
• Mitotic count: 0 (<5/50 HPF)
• submucosal
 low risk
Bucher et al and Fletcher et al. 2002
• CD117 (C-kit) positiv
• Ki67-antigenexpression < 2%

7. Verret et al. 2000, Bucher et al. 2004 , Fletcher et al. 2002
Dr. med. P. Lingohr St. Franziskus Hospital, Cologne
Conclusions:
• Low risk tumor  en-bloc-resection with tumorfree margins and observation
Verret et al. 2000, Bucher et al , Fletcher et al. 2002
• The resection can be done by an endoscopic-laparascopic rendezvous-operation  laparoscopic wedge resection (LWR)
Ohgami et al and 2000, Choi et al. 2000, Ludwig et al. 2002

8. Mrs. PD Dr. med. C. Wickenhauser,
Dr. med. P. Lingohr St. Franziskus Hospital, Cologne
Thanks to:
Mrs. PD Dr. med. C. Wickenhauser,
Department for Pathology at the university of cologne
(Direktor: Prof. Dr. med. Dienes)

9. Dr. med. P. Lingohr St. Franziskus Hospital, Cologne
See you in Cologne!!!