Gastrointestinal stromal tumor (GIST) arises from gastrointestinal tract, omentum, mesentery or peritoneal surface. Of which, about 60% arises from stomach. The principle of surgical treatment is removing the tumor as completely as possible. The indications of operation for metastatic and recurrent GIST are perforation, obstruction and hemorrhage. The majority of gastric stromal tumor can be removed with local or wedge excision. Proximal gastrectomy is a choice for GIST locating at the cardia since local resection may cause cardia stenosis. Distal gastrectomy is suitable for GIST locating at lesser curvature of gastric antrum. Total gastrectomy is not a common procedure for gastric stromal tumor. Combined spleen, tail of pancreas and transverse colon resection may necessary for R0 surgery. Local resection is the first choice for duodenal stromal tumor, pancreaticoduodenectomy can be performed in large medical center. Operative procedure must be carefully carried out for small intestinal stromal tumor to avoid tumor rupture. Combined resection is a right choice when tumor involved surrounding organs or structures. In principle, low anterior instead of abdominoperineal resection is the only recommend procedure for rectal stromal tumor.
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