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Surgical Endoscopy
Published in: Surgical Endoscopy 9/2014

01-09-2014

Laparoscopic versus open gastric resection for larger than 5 cm primary gastric gastrointestinal stromal tumors (GIST): a size-matched comparison

Authors: Jianxian Lin, Changming Huang, Chaohui Zheng, Ping Li, Jianwei Xie, Jiabin Wang, Jun Lu

Published in: Surgical Endoscopy | Issue 9/2014

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Abstract

Background

Laparoscopic resection of gastric gastrointestinal stromal tumors (GISTs) appears technically feasible and associated with favorable outcomes. Tumor size plays an important role in surgical approach, with laparotomy tending to be used to treat larger tumors. This study evaluated the technical feasibility, safety, and oncologic efficacy of laparoscopic surgery for GISTs ≥5 cm in diameter.

Methods

One hundred forty patients who underwent resection of primary gastric GIST at our institution from January 2007 to December 2012 were identified. Twenty-three patients with tumor larger than 5 cm in diameter treated by laparoscopic resection and were randomly matched (1:1) by tumor size (±1 cm) to patients with open resection. Clinical and pathologic variables and surgical outcomes for each surgical type were identified and compared.

Results

There were no significant differences in clinicopathologic characteristics between the two groups. Laparoscopic group was superior to open group in operation time, blood loss, time to ground activities, time to first flatus, times to liquid diet, and postoperative stay (P < 0.05). Number of transfusions and time to semi-liquid diet, however, did not differ between groups. There was no operative mortality, and the postoperative complications were similar. Fifteen patients in the laparoscopic group and 17 patients in the open group received adjuvant treatment with imatinib. Recurrence or metastasis occurred in eight cases (three in the laparoscopic group and five in the open group). No significant difference in long-term disease-free survival was found between the two groups (P > 0.05).

Conclusion

When performed by experienced surgeons, laparoscopic resection for gastric GISTs larger than 5 cm is a safe and effective minimally invasive surgery.
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Metadata
Title
Laparoscopic versus open gastric resection for larger than 5 cm primary gastric gastrointestinal stromal tumors (GIST): a size-matched comparison
Authors
Jianxian Lin
Changming Huang
Chaohui Zheng
Ping Li
Jianwei Xie
Jiabin Wang
Jun Lu
Publication date
01-09-2014
Publisher
Springer US
Published in
Surgical Endoscopy / Issue 9/2014
Print ISSN: 0930-2794
Electronic ISSN: 1432-2218
DOI
https://doi.org/10.1007/s00464-014-3506-x

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