Vy C Dang1*, Rebecca E Wu2, Neesha Siriwardane3, Mukul K Divatia3,4 and Rodolfo J Oviedo1,2,4
1Texas A&M University School of Medicine, Bryan, TX, USA 2Houston Methodist Department of Surgery, Houston, TX, USA 3Department of Pathology and Genomic Medicine, Houston Methodist Hospital, Houston, TX, USA 4Weill Cornell Medical College, Cornell University, New York, NY, USA
*Corresponding Author: Vy C Dang, Texas A&M University School of Medicine, Bryan, TX, USA.
Received: March 23, 2023; Published: April 11, 2023
Background: Gastrointestinal stromal tumors (GIST) account for 1-2% of gastrointestinal neoplasms. Their metastatic risk is highly dependent on tumor size. While imatinib mesylate can be used for metastatic disease, the primary approach for GIST management is surgical resection. This case explores the use of robotic-assisted laparoscopic small bowel resection and intracorporeal anastomosis as an early intervention for GIST.
Summary: A 64-year-old female with a history of hypercholesterolemia presented with a four-day history of vague lower abdominal pain. Computed tomography (CT) scan revealed a 3.7 cm mesenteric mass in the small bowel, 30 cm distal to the ligament of Treitz. The patient underwent a robotic-assisted laparoscopic proximal jejunal resection and intracorporeal anastomosis with an en bloc resection of the GIST. Pathologic evaluation revealed a low-grade, low-risk spindle-cell GIST, with strong and diffuse c-KIT (CD117) and DOG1 positivity on immunohistochemical staining and without lymphovascular invasion. Molecular analysis by next-generation sequencing did not demonstrate any mutations in KIT, PDGFRA and BRAF genes. Given the complex etiology of vague abdominal symptoms, obtaining an accurate diagnosis requires a proper patient history and physical, in combination with imaging and laboratory findings. Robotic surgery has proven to be an increasingly accessible and valuable approach to resection of gastrointestinal tumors.
Conclusions: Gastrointestinal tumors of the small bowel require early intervention and can be resected via robotic-assisted laparoscopic surgery. Oncologic work up must be completed after the procedure to guide development of a multi-disciplinary oncologic treatment plan.
Keywords: GIST; Robotic Surgery; Bowel Resection; Anastomosis; Neoplasm
Citation: Vy C Dang., et al. “Robotic Small Bowel Resection with Intracorporeal Anastomosis for a Proximal Jejunal Gastrointestinal Stromal Tumor: A Case Report". Acta Scientific Gastrointestinal Disorders 6.5 (2023): 15-18.
Copyright: © 2023 Vy C Dang., et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.