Laparoscopic vs open resection of gastric stromal tumors

Abstract

Laparoscopic resection of gastric stromal tumors is safe and appropriate. Tumor size, operating time, and estimated blood loss were equivalent to the open approach, and there was a statistically shorter hospital stay in the laparoscopic group.

Laparoscopic Wedge Resection for Gastric Submucosal Tumors: A Size-Location Matched Case-Control Study

“…During a mean follow-up period (Table 4). 3 showed that laparoscopic resection of gastric stromal tumors was safe and appropriate, and that the laparoscopic group had a shorter hospital stay. Moreover, various laparoscopic approaches for resection of gastric SMTs have been developed, depending on size, location, and transmural characteristics.…”

“…As mentioned, although there have been studies to show the benefits of the laparoscopic wedge approach, they did not have enough patients and did not indicate the size or location of gastric SMTs. 3,11,17 By careful case-matching, we analyzed a total of 100 procedures consisting of 50 LWRs and 50 OWRs. In size-matching, tumors between 2 and 5 cm accounted for the largest proportion (68%), and tumors larger than 5 cm accounted for 12%; the largest diameter in the LWR group was 6 cm.…”

“…Although the feasibility of LWR for gastric SMTs has been established, [2][3][4] this procedure may be limited by tumor size or location. The GIST Consensus Conference recommended that laparoscopic resection for gastric GISTs should be limited to tumors smaller than 2 cm, due to the increased risk of tumor rupture and peritoneal seeding.…”

Laparoscopic Intra-Gastric Resection of Gastric Sub-Mucosal Tumors under Oral Endoscopic Guidance

“…Tables 3 and 4 summarize several reported series of laparoscopic intragastric resections for GSTs, with the exception of a single case report [7,[9][10][11][12][13][14][15]. The number of cases ranged from 3 to 11, with a mean of 6.7, and the mean patient age was 71 years (range, 65-77 years).…”

Gastrointestinal Stromal Tumors

“…The primary goal is to remove the tumor with tumor free margins since 5-year overall survival in GIST patients with complete gross resection has been estimated at 42% compared to only 9% overall survival if the excision was incomplete [70]. GIST can usually be lifted away from surrounding structures, rarely spread into adjacent organs and therefore offer an excellent opportunity for laparoscopic tumor resection with efficacy and recurrence rates similar or superior to historical open surgical controls [71][72][73][74]. When the tumor attaches to other organs, en bloc resection is appropriate.…”