This is a good debate indeed. I don't see any advantage of sleeve gastrectomy vs Roux-en-Y gastric bypass with complete resection of the gastric remnant, or  even total gastrectomy (with the exception of oesophageo-jejunal dysmotility in the first 2 years) from the bariatric point of view.

the problem with the sleeve resection is that one needs more tissue to have the adequate resection one is looking for. A small GIST might easily be treated by a sleeve like resection. In the larger tumors I would perform a roux en Y reconstruction after (partial) gastrectomy

The criteria for GIST treatment in all accepted guidelines

is a free-margin resection; there is no need for wide margin resection or lymphadenectomy. In this sense, and from an oncological point of view, sleeve seems only reasonable for a GIST with very wide implantation`s base along the greater curvature of the stomach.

http://www.nccn.org/professionals/physician_gls/pdf/sarcoma.pdf

Dear Dr Renward, I think my question is regarding GIST and not Bariatric surgery.

sleeve gastrectomy is an acceptable option for GIST if you are able to achieve margin with sufficient remnant stomach.

Dr.Reddy,

Good question is this.

I think it depends on size of the tumour. In general, a wedge resection would be good enough for a rather small lesion.

The sleeve resection may have some side effect for the same reason it used in the bariatric surgery (loss of appetite, etc.). I have no own experience of the sleeve resections in relatively health patients, though.

If patient  is then only we can think of .Otherwise wedge resection  is good enough  for  GIST.

The main reasons to consider sleeve rather than a wedge resection would be if there is a wide based large lesion on the greater curve or if you think a large gastric body wedge resection might produce an hour glass stomach that functions poorly