Surgical management of XXXX : analysis of outcome with respect to surgical margins and technique.

@entity1 @entity5 @entity3 @entity2467 @entity361 @entity674
This report reviews the methods and goals of treatment of @entity674 ( @entity674 ), the most common @entity361 of the gastrointestinal tract. GISTs express @entity2467 , which serves as an immunohistochemical diagnostic marker. Surgical excision is the definitive treatment for all primary GISTs greater than 2 cm without evidence of peritoneal seeding or @entity3 . Preoperative or intraoperative biopsy is not indicated except when the differential diagnosis includes another type of @entity5 . Resection may be performed by traditional open surgery or by laparoscopic or laparoscopy-assisted procedures. Regardless of the approach, oncological precautions must be strictly observed. @entity5 disruption is to be avoided at all costs; @entity5 enucleation leaves a @entity5 -seeded pseudocapsule behind and is considered insufficient. Because GISTs rarely metastasize through the lymphatics, routine lymphadenectomy is not indicated. The importance of achieving negative microscopic margins is controversial, although @entity1 who undergo incomplete microscopic resection may be at greater risk of locoregional recurrence. Other factors, such as @entity5 grade and size, may play a more significant role in predicting recurrence. Cases of advanced disease or involvement of adjacent structures should be evaluated on an individual basis by a multidisciplinary team.
