Laparoscopic extramucosal excision of gastric gastrointestinal stromal tumor

Gastrointestinal stromal tumors (GISTs) are mesenchymal neoplasms arising from interstitial cells of Cajal with predominant localization in the stomach. Modern surgical management of localized gastric GISTs favors minimally invasive organ-sparing techniques ensuring total resection (R0) and reducing recovery time. This article presents laparoscopic submucosal excision of gastric antral GIST in a 63-year-old female with multiple comorbidities. A 4-cm tumor arising from muscular layer was resected without mucosal disruption. Postoperative period was uneventful, and histological examination confirmed R0 resection with low proliferative activity (Ki-67 3%). No recurrence was detected throughout 20 months. Analysis of literature data highlights the advantages of submucosal approach for small (≤5 cm) extramural gastric GISTs, including technical simplicity, lower intraoperative risks, and preserved organ function. Key selection criteria include tumor location (anterior wall/greater curvature), growth from muscular layer and no adhesions. This case supports feasibility of laparoscopic submucosal resection in carefully selected patients. Further multiple-center studies are needed to standardize this technique and evaluate long-term outcomes.