Abstract
Background
Although the feasibility of minimally invasive resection of small gastric GISTs is
well established, less is known about safety and efficacy of laparoscopic surgery
for large tumors.
Methods
A retrospective analysis was performed, using a prospectively maintained comprehensive
database. Patients were divided into two groups according to tumor size: Case group
with tumors > 5 cm and control group with tumors <5 cm. Hospital charts were reviewed,
and various outcome measures recorded, including operative time, estimated operative
blood loss, post-operative leak, stasis, infection and recurrence.
Results
No tumors were ruptured during surgical manipulation and no major morbidity or mortality
occurred in either group. Operative time (75,8 ± 33,1 min in large cases vs 75,8 ± 33,1 min
in small cases) was similar in both groups (p = 0,61). The incidence of post-operative
complications did not differ between the two groups. In details there were 21 out
of 25 (84%) uncomplicated cases among small GISTs versus 17 out of 24 (70,8%) uncomplicated
cases among large GISTs (p = 0,32).
Conclusion
This matched-pair case control study demonstrates that laparoscopic wedge resection
for large gastric GISTs is safe and effective, as demonstrated for small tumors.
Keywords
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References
- Gastrointestinal stromal tumors.Br J Surg. 2003; 90: 1178-1186
- Outcome after surgical treatment of suspected gastrointestinal stromal tumors involving the duodenum: is limited resection appropriate?.J Surg Oncol. 2008; 97: 388-391
- Which is the optimal risk stratification system for surgically treated localize primary GIST? Comparison of three contemporary prognostic criteria in 171 tumors and a proposal of a modified Armed Forces Institute of Pathology risk criteria.Ann Surg Oncol. 2008; 15: 2153-2163
- A systematic review and meta-analysis comparing laparoscopic versus open gastric resections for gastrointestinal stromal tumors of the stomach.Ann Surg Oncol. 2013; 20: 3549-3560
- Outcome after laparoscopic versus open wedge resection for suspected gastric gastrointestinal stromal tumors: a matched-pair case-control study.EJSO. 2015; 41: 905-910
- Impact of the introduction of laparoscopic wedge resection as a surgical option for suspected small/medium-sized gastrointestinal stromal tumors of the stomach on perioperative and oncologic outcomes.World J Surg. 2010; 34: 1847-1852
- Long-term outcomes of laparoscopic resection of gastric gastrointestinal stromal tumors.Ann Surg. 2006; 243 (discussion 745–747): 738-745
- Laparoscopic gastric resection for gastrointestinal stromal tumors.Surg Endosc. 2008; 22: 2583-2587
- Operative indications for relatively small (2–5 cm) gastrointestinal stromal tumor of the stomach based on analysis of 60 operated cases.Surgery. 2006; 139: 484-492
- Tailored laparoscopic resection for suspected gastric gastrointestinal stromal tumors.Surgery. 2006; 139: 484-492
- Laparoscopic versus open gastric resections for primary gastrointestinal stromal tumors (GISTs): a size-matched comparison.Ann Surg Oncol. 2011; 18: 1599-1605
- Management of malignant gastrointestinal stromal tumor.Lancet Oncol. 2002; 3: 664
- Laparoscopic wedge resection of gastric tumor.Hepatogastroenterology. 1999; 46: 2100-2104
- Laparoscopic resection of gastric stromal tumor: a tailored approach.Ann Surg. 2003; 69: 946-950
- Laparoscopic resection of gastric gastrointestinal stromal tumors (GIST) is safe and effective, irrespective of tumor size.Surg Endosc. 2012; 26: 2339-2345
- NCCN Task Force report: management of patients with gastrointestinal stromal tumor (GIST) – update of the NCCN clinical practice guidelines.J Natl Compr Cancer Netw. 2007; (Suppl 2: S1–S29 (quiz S30). 44)
- NCCN Task Force report: update on the management of patients with gastrointestinal stromal tumors.J Natl Compr Cancer Netw. 2010; 8 (S1-41 quiz S42–44)
- Laparoscopic resection for large gastric gastrointestinal stromal tumor (GIST): intermediate follow-up results.Surg Endosc. 2015; 29: 868-873
- Classification of surgical complications: a new proposal with evaluation in a cohort of 6336 patients and results of a survey.Ann Surg. 2004; 240: 205-213
- Gastrointestinal pacemaker cell tumor (GIPACT): gastrointestinal stromal tumors show phenotypic characteristics of the interstitial cells of Cajal.Am J Pathol. 1998; 152: 1259-1269
- Long-term and surgical outcomes of laparoscopic surgery for gastric gastrointestinal stromal tumors.Surg Endosc. 2014; 28: 2317-2322
- Two hundred gastrointestinal stromal tumors: recurrence patterns and prognostic factors for survivol.Ann Surg. 2000; 231: 51-58
- Epidemiology of gastrointestinal stromal tumors: single-institution experience and clinical presentation over three decades.Cancer Epidemiol. 2011; 35: 515-520
- Malignant gastrointestinal stromal tumor: distribution, imaging features, and pattern of metastatic spread.Radiology. 2003; 226: 527-532
- Gastrointestinal stromal tumor-definition, clinical, histological, immunohistochemical, and molecular genetic features and differential diagnosis.Virchows Arch. 2001; 438: 1-12
- Minimally invasive surgery for gastric stromal cell tumors: intermediate follow-up results.J Gastrointest Surg. 2006; 10: 563-566
- Management of gastrointestinal stromal tumors in the imatinib era: selected case studies.Oncologist. 2006; 11: 9-20
- Surgery and imatinib in the management of GIST: emerging approaches to adjuvant and neoadjuvant therapy.Ann Surg Oncol. 2004; 11: 465-475
- Laparoscopic versus open gastric resections for gastric gastrointestinal stromal tumors: a meta-analysis.Surg Laparosc Endosc Percutan Tech. 2013; 23: 378-387
- Laparoscopic versus open resection of gastrointestinal stromal tumors of the stomach.Surg Endosc. 2013; 27: 1546-1554
- Laparoscopic management of gastrointestinal stromal tumors.Surg Endosc. 2006; 20: 713-716
- Laparoscopic wedge resection for gastric GIST: long-term follow-up results.Eur J Surg Oncol. 2007; 33: 444-447
- Long term survival results for gastric GIST: i laparoscopic surgery for large gastric GIST feasible?.World J Surg Oncol. 2012; 10: 230
- Laparoscopic resection of benign stromal tumors of the stomach.J Laparoendosc Surg. 1992; 2: 331-334
- Laparoscopic wedge resection of gastric submucosal tumors: a size-location matched case-control study.J Am Coll Surg. 2011; 212: 195-199
- Gastrointestinal stromal tumors: ESMO Clinical Practice Guidelines for diagnosis, treatment and follow-up.Ann Oncol. 2012; 23: vii49-vii55
- Risk stratification of patients diagnosed with gastrointestinal stromal tumor.Hum Pathol. 2008; 39: 1411-1419
- Gastrointestinal stromal tumors (GIST) and laparoscopic resection.Surg Endosc. 2007; 21: 1685-1689
- Totally laparoscopic resection for a large gastrointestinal stromal tumor of stomach.J Gastric Cancer. 2011; 11: 239-242
- Laparoscopic versus open gastric resection for larger than 5 cm primary gastric gastrointestinal stromal tumors (GIST): a size-matched comparison.Surg Endosc. 2014; 28: 2577-2583
- Learning curve of laparoscopic surgery for gastric cancer, a laparoscopic distal gastrectomy-based analysis.Surg Endosc. 2009; 23: 1259-1264
Article info
Publication history
Published online: January 18, 2017
Accepted:
January 3,
2017
Identification
Copyright
© 2017 Elsevier Ltd, BASO ~ The Association for Cancer Surgery, and the European Society of Surgical Oncology. All rights reserved.
