{
  "abstract": "Gastrointestinal Stromal Tumors (GISTs) in Neurofibromatosis Type 1 (NF-1) are typically multifocal, small-bowel-based, and wild-type for KIT and PDGFRA, so surgery remains the cornerstone of treatment. Multifocal duodeno-jejunal involvement poses technical and strategic challenges, and minimally invasive management in this setting is poorly standardized. We describe a hybrid laparoscopic–mini-open, bowel-preserving approach. Laparoscopic access via the Hasson technique with three additional trocars allows systematic small-bowel exploration. Division of the ligament of Treitz and a complete Kocher maneuver fully mobilize the duodeno-pancreatic block. Targeted lesions are exteriorized through a short Alexis-protected minilaparotomy and removed by manual full-thickness wedge resection with double-layer closure. A selective strategy is applied: only enlarging or anatomically critical lesions are resected, while subcentimeter micro-GISTs are left in situ . In a 62-year-old man with NF1 and three growing GISTs (duodenal and jejunal), all targeted lesions were resected with negative (R0) margins. Histology confirmed low-risk and no risk tumors. Recovery was uneventful aside from transient delayed gastric emptying, and the patient was recurrence-free at 12 months. This standardized, reproducible technique provides a tailored minimally invasive option for multifocal NF1-associated GISTs, preserving bowel length without compromising oncologic adequacy.",
  "abstract_shown": true,
  "affiliations": [
    "Sarcoma, Melanoma and Rare Tumors Surgery Unit, IRCCS Humanitas Research Hospital, Rozzano",
    "Humanitas University, Pieve Emanuele",
    "Department of Biomedical Sciences, Humanitas University, Pieve Emanuele",
    "Pathology Department, IRCCS Humanitas Research Hospital, Rozzano"
  ],
  "article_type": null,
  "arxiv": null,
  "author_total": 10,
  "authors": [
    {
      "affs": [
        0
      ],
      "name": "Laura Samà"
    },
    {
      "affs": [
        1
      ],
      "name": "Federica Bezzi"
    },
    {
      "affs": [
        0,
        2
      ],
      "name": "Marta Casiraghi"
    },
    {
      "affs": [
        0
      ],
      "name": "Vittoria D’Amato"
    },
    {
      "affs": [
        0,
        2
      ],
      "name": "Sonia Kumar"
    },
    {
      "affs": [
        0
      ],
      "name": "Laura Ruspi"
    },
    {
      "affs": [
        0
      ],
      "name": "Federico Sicoli"
    },
    {
      "affs": [
        2,
        3
      ],
      "name": "Salvatore Lorenzo Renne"
    },
    {
      "affs": [
        0
      ],
      "name": "Vittorio Lorenzo Quagliuolo"
    },
    {
      "affs": [
        0,
        2
      ],
      "name": "Ferdinando Carlo Maria Cananzi"
    }
  ],
  "bibtex": "https://research.draconitic.com/paper/2gm1zk3jb29k0.bib",
  "cited_by": 0,
  "doi": "10.3389/fonc.2026.1909970",
  "fulltext_url": null,
  "id": "2gm1zk3jb29k0",
  "issns": [
    "2234-943X"
  ],
  "landing_url": "https://www.frontiersin.org/articles/10.3389/fonc.2026.1909970/full",
  "language": null,
  "licence": "CC-BY-4.0",
  "licence_label": "CC BY 4.0",
  "licence_source": "article",
  "licence_url": "https://creativecommons.org/licenses/by/4.0/",
  "metadata_licence": null,
  "native_subjects": [],
  "openalex": null,
  "pdf_url": null,
  "pmcid": null,
  "pmid": null,
  "published": "2026-10-30",
  "publisher": "Frontiers Media SA",
  "ris": "https://research.draconitic.com/paper/2gm1zk3jb29k0.ris",
  "sources": [
    {
      "first_seen": "2026-10-30T12:20:14Z",
      "native_id": "10.3389/fonc.2026.1909970",
      "source": "crossref",
      "url": "https://www.frontiersin.org/articles/10.3389/fonc.2026.1909970/full"
    }
  ],
  "subjects": [
    {
      "field": "medicine",
      "origin": "issn:2234-943X",
      "subfield": "oncology"
    }
  ],
  "title": "Minimally invasive resection of multifocal duodeno-jejunal gastrointestinal stromal tumors in neurofibromatosis type 1",
  "title_text": "Minimally invasive resection of multifocal duodeno-jejunal gastrointestinal stromal tumors in neurofibromatosis type 1",
  "type": "peer-reviewed",
  "updated_at": "2026-11-01T00:21:05Z",
  "url": "https://research.draconitic.com/paper/2gm1zk3jb29k0",
  "venue": "Frontiers in Oncology",
  "versions": []
}