对于原发的且病灶局限的胃肠间质瘤（GIST），手术治疗依然是首选的治疗方案。自伊马替尼被用于治疗GIST以来，对于广泛或巨大原发灶，以及复发转移的GIST病人，如何选择手术治疗或靶向药物治疗以及如何把握两者联合治疗，至今仍有争论，尚须进一步探讨。由于伊马替尼对病人的凝血功能可能有影响，对于服药后的GIST病人进行手术治疗时，术中出血量可能较大，所以术前应先停药且纠正凝血功能。

Status of surgical treatment in recurrent and metastatic gastrointestinal stromal tumors        SHI Ying-qiang, Department of Abdominal Surgery, Cancer Hospital, Fudan University, Shanghai 200032, China
Abstract    Surgical treatment is still first choice in primary and local gastrointestinal stromal tumors (GIST). Imatinib was applied in the treatment of GIST patients. How to choose surgical treatment or targeted drug and how to select the combination of the two treatment options in patients with a huge or multiple mass and recurrent and metastatic GIST patients are still controversial, which need further investigation. Amount of bleeding during operation may be much more in GIST patients who choose targeted drug treatment in advance because the blood coagulation function of GIST patients might be affected by imatinib. Therefore, it is necessary to halt the drug and improve the blood coagulation function of GIST patients before operation.