A gastrointestinal stromal tumor (GIST) is a cancerous tumor that grows in the digestive tract. Surgery can help remove the entire tumor. There are several procedures, including laparoscopy or more traditional open surgery.

Surgery — when possible — is the primary treatment for GISTs that have not spread. In some cases where the tumor is very small, surgery may only be necessary if the tumor grows or the individual begins to experience symptoms.

As with all medical procedures, GIST surgery comes with the risk of complications. A doctor may not advise surgery in cases where cancer has spread throughout the body (called metastatic cancer) or the tumor cannot be removed safely. Imaging, such as CT scans, may be necessary before or after surgery to monitor and follow up.

This article will discuss different types of surgeries to remove GISTs and provide tips for choosing a surgeon. It also answers some frequently asked questions on the topic.

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Surgery is the primary treatment for small GISTs of at least 2 centimeters (cm). For GISTs smaller than 2 cm, a doctor may not always recommend surgery.

Laparoscopy

Laparoscopy is a minimally invasive procedure that surgeons often use to remove small GISTs.

During laparoscopy, the surgeon makes only a few small incisions. The surgeon then inserts a small tube with a light and camera attached to its end (a laparoscope) through one of the incisions.

The laparoscope allows the surgeon to see inside the body. Using specialist tools, the surgeon removes the tumor and a margin of healthy tissue. This is to avoid rupturing the tumor, which may cause the cells to spread to another part of the body.

Some risk associated with this procedure is bleeding, as many GISTs can have various blood vessels supplying them with nutrients. A surgeon can help manage the bleeding.

The recovery time for this minimally invasive procedure is usually shorter than for more invasive surgeries. A 2017 study found that laparoscopic resection for GISTs resulted in fewer complications and a shorter hospital stay than open surgery.

While there is an increasing trend in the medical literature for minimally invasive and endoscopic approaches for removing GISTs, surgery remains the gold standard.

In some cases, a surgeon can remove a GIST that is large or growing into an organ. This will involve open or extensive surgery.

Open surgery

Open surgery requires a larger incision than a minimally invasive procedure. The surgeon may need to remove a small part of the organ invaded by the tumor, to ensure that they remove the GIST in its entirety. However, this will depend on the location and size of the tumor.

Types of procedures for large GIST removal include:

  • partial intestine resection, which involves removing part of the intestine
  • partial gastrectomy, which involves removing part of the stomach
  • abdominoperineal resection, which involves removing parts of the rectum and anus
  • Whipple procedure, which involves removing part of the pancreas, intestine, and possibly other organs

Recovery time will depend on which procedure an individual has and other factors such as age. A person will usually stay in the hospital for 7–10 days and be able to walk within 24 hours after surgery. Generally, recovery takes between 3 and 6 weeks.

Surgery is not the primary treatment for GISTs that have spread from their original location to other body parts. Doctors usually treat these GISTs with targeted therapy drugs, which can help shrink the tumors. However, a doctor may recommend surgery for metastatic GISTs in cases where they are causing certain complications.

Also, a doctor may consider surgical procedures if surgery is part of a treatment plan. It is important to understand that surgery for metastatic GISTs — even as part of a treatment plan — does not provide a cure. Further, more research is needed to understand the benefits of surgery for metastatic GISTs.

GISTs are an uncommon type of tumor, so selecting a surgeon with experience in GIST removal surgery is vital. This is partly due to the possibility of causing complications. Complications can include bleeding or rupturing of the tumor, which may cause the cancer to spread.

An individual should consider choosing a surgeon with extensive experience in treating cancer and with whom they are comfortable. They may also need to consider whether a surgeon accepts their health insurance or is a part of their health insurance plan.

Below are some commonly asked questions about GIST surgery:

How long does it take to recover from GIST surgery?

Overall recovery usually takes 3–6 weeks, with about 7–10 days of hospital stay. Individuals can usually walk within 24 hours after surgery and eat within a few days.

How successful is GIST surgery?

GIST removal surgery can be curative if the tumors have not begun to spread. According to a 2016 review, 60% of GISTs that can be surgically removed do not reoccur after removal.

How serious is a GIST?

The seriousness of a GIST depends on whether the cancer has spread throughout the body, the size and location of the tumor, and whether doctors can remove it surgically.

Also, a doctor can assess how serious a tumor is using based on the cancer stage.

How long does GIST surgery take?

The length of the surgery will depend on the type of procedure the surgeon is performing and other factors, such as the tumor’s location.

Surgery is the main treatment method for a GIST that has not begun to spread throughout the body. A surgeon may recommend various procedures for GIST removal depending on the size and location of the tumor. These can include laparoscopy and, for larger tumors, open surgery. Surgeons may sometimes perform surgery to remove metastatic GISTs, but this will not be a curative treatment.

Some GISTs may be more severe than others, and the type of treatment offered and recovery periods will vary based on an individual’s specific circumstance.