RT Book, Section A1 Hunter, John G. A1 Spight, Donn H. A1 Sandone, Corinne A1 Fairman, Jennifer E. SR Print(0) ID 1162530440 T1 Wedge Resection of Gastric Smooth Muscle Tumors T2 Atlas of Minimally Invasive Surgical Operations YR 2018 FD 2018 PB McGraw-Hill Education PP New York, NY SN 9780071449052 LK accesssurgery.mhmedical.com/content.aspx?aid=1162530440 RD 2024/03/28 AB Gastric smooth muscle tumors may either be leiomyomas or gastrointestinal stromal tumors. The gastrointestinal stromal tumors are characterized by their larger size (usually >1 cm), by the number of mitoses, and by the presence of a C-Kit mutation on exon 9 or 11. Although the differentiation between leiomyoma and gastrointestinal stromal tumor (GIST) is a relatively new distinction, it has some importance from a surgical perspective, as GISTs have a greater propensity for recurrence and must be resected with a margin of normal stomach circumferentially. On the other hand, leiomyomas, which are most common in the esophagus, can also be found in the proximal stomach. These can be treated with either wedge resection or an endogastric “shelling out” when they are small and symptomatic (see Chapter 38). Asymptomatic lesions less than 1 cm can generally be observed.