RT Journal
A1 Harold KL, Huguet KL, Rush RM, Jr, et al
T1 OPen or laparoscopic resection of a large gastric gastrointestinal stromal tumor—reply
JF Archives of Surgery
JO Archives of Surgery
YR 2009
FD February 1
VO 144
IS 2
SP 193
OP 197
DO 10.1001/archsurg.2008.554
UL http://dx.doi.org/10.1001/archsurg.2008.554
AB 
Avoidance of tumor rupture is of utmost importance during GIST resection. Tumors in difficult locations can be manipulated by use of nontraumatic graspers on the stomach wall near the tumor, avoiding direct tumor manipulation. Alternatively, a stitch can be placed near the tumor in normal tissue for retraction. We will typically approach GIST tumors with invasion into adjacent organs through an open operation, though we may begin with diagnostic laparoscopy to confirm invasion that is suspected on preoperative imaging.