Laparoscopic resection of gastric leiomyosarcoma.

Wedge resection with a normal margin of stomach is generally considered adequate therapy for gastric leiomyosarcoma. We report here four patients with gastric leiomyosarcoma managed laparoscopically. The technique is described. There were no operative complications and all patients have been followed for 7 to 56 months. Three patients are free of disease and one patient with a high grade tumor is alive with liver metastases at 2 yars postoperatively. From this experience we conclude the following: 1) Laparoscopic wedge resection of gastric leiomyosarcoma is straightforward and easily accomplished without violation of standard surgical oncologic principles. 2) Intraoperative endoscopy is helpful in locating and manipulating the tumor, and aids in ensuring lumenal adequacy and staple line integrity. 3) Preoperative localizing studies may be misleading and should not discourage laparoscopic evaluation and treatment.