Long-term Outcomes of Laparoscopic Wedge Resection for Gastrointestinal Stromal Tumors of the Stomach of Less Than 5 cm in Diameter

Amin, Anwar Tawfik; Kono, Yohei; Shiraishi, Norio; Yasuda, Kazuhiro; Ito, Masafumi; Kitano, Seigo

doi:10.1097/sle.0b013e318220f1c7

Cited by 12 publications

(12 citation statements)

References 19 publications

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“…[3][4][5][6] The technique is, however, more controversial for gastric adenocarcinoma. A large body of evidence comes from the Asian literature.…”

Section: Discussionmentioning

confidence: 99%

“…The first laparoscopic gastric resection was reported in 1993. 2 Since then, minimally invasive gastric surgery has gained general acceptance for benign conditions [3][4][5] and some malignant ones for which extended resection or lymphadenectomy is not required. 3,6 Its role in the treatment of gastric adenocarcinoma is still debated.…”

mentioning

confidence: 99%

“…2 Since then, minimally invasive gastric surgery has gained general acceptance for benign conditions [3][4][5] and some malignant ones for which extended resection or lymphadenectomy is not required. 3,6 Its role in the treatment of gastric adenocarcinoma is still debated. The extensive Asian experience, where gastric cancer is diagnosed at an early stage, has confirmed the adequacy of laparoscopic resection with regards to postoperative outcomes, technical feasibility of appropriate lymphadenectomy and oncologic outcomes.…”

mentioning

confidence: 99%

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Oncologic specimen from laparoscopic assisted gastrectomy for gastric adenocarcinoma is comparable to D1-open surgery: the experience of a Canadian centre

Hallet

Labidi²,

Bouchard‐Fortier³

et al. 2013

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Background:The Eastern experience has reported the safety of laparoscopic assisted gastrectomy (LAG) for gastric cancer. Its use in Western countries is still debated owing to concerns about its oncologic equivalence to open gastrectomy (OG). We sought to review and compare their operative outcomes and oncologic specimen quality (number of harvested lymph nodes and surgical margins) for gastric adenocarcinoma (GA). Methods:We reviewed the charts of all patients undergoing LAG (2007( ) and OG (2000 for GA in a single institution. Several surgeons performed the OGs, whereas 1 fellowship-trained laparoscopic surgeon performed LAGs. The primary outcome was quality of the surgical specimen, assessed by the number of harvested lymph nodes (LNs) and margin status. Secondary outcomes were perioperative events. Data were analyzed as intention to treat. Results:We retrieved 60 cases (47 OGs, 13 LAGs). The conversion rate was 23%. Conclusion:Laparoscopic assisted gastrectomy is a challenging but safe and feasible procedure in experienced hands. It offers the same radical resection as OG regarding negative margins and LN retrieval. Long-term follow-up is warranted.Contexte : La gastrectomie assistée par laparoscopie (GAL) a été démontrée dans des études orientales comme sécuritaire dans le traitement de l'adénocarcinome gastrique (AG). En occident, l'équivalence oncologique de la GAL avec la gastrectomie ouverte (GO) demeure cependant controversée. Cette étude vise à comparer le devenir postopératoire et la qualité des spécimens oncologiques de ces interventions, dans le traitement de l'AG. (2007)(2008)(2009)(2010) ou GO (2000GO ( -2010 pour AG dans un seul centre hospitalier ont été revus. Différents chirurgiens ont réalisé les GO. Toutes les GAL ont été réalisées par un seul chirurgien sur-spécialisé en chirurgie laparoscopique. Le critère d'évaluation principal était la qualité du spécimen chirurgical évaluée par le nombre de ganglions lymphatiques (GL) prélevés et le statut des marges de résection. Le critère d'évaluation secondaire était la morbidité postopératoire. Les données ont été analysées en fonction de l'intention de traiter. Méthodes : Tous les dossiers de patients opérés par GALRésultats : Soixante cas ont été inclus (47 GO, 13 GAL). Le taux de conversion s'est établi à 23 %. Le temps opératoire moyen était plus long de 115 minutes, et les pertes sanguines moyennes moindres de 425 mL (p < 0,001 dans les 2 cas) pour la GAL que pour la GO. Une moyenne de 14,4 (écart-type [ET] 9,8) et 11,2 (ET 8,2) GL ont été prélevés respectivement pour la GO et la GAL (p = 0.29). On a obtenu des marges négatives pour tous les patients. La durée moyenne du séjour ne différait pas (GAL 19 j c. GO 18,9 j; p = 0,91). Les complications majeures (12,7 % c. 23,1 %; p = 0,39) et la mortalité post-opératoires (2,1 % c. 7,7 %; p = 0,32) étaient similaires. Conclusion :La gastrectomie assistée par laparoscopie est une intervention complexe, mais peut être réalisée de manière sécuritaire en des mains expertes. Elle offre un spécimen onc...

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“…[3][4][5][6] The technique is, however, more controversial for gastric adenocarcinoma. A large body of evidence comes from the Asian literature.…”

Section: Discussionmentioning

confidence: 99%

mentioning

confidence: 99%

mentioning

confidence: 99%

See 1 more Smart Citation

Oncologic specimen from laparoscopic assisted gastrectomy for gastric adenocarcinoma is comparable to D1-open surgery: the experience of a Canadian centre

Hallet

Labidi²,

Bouchard‐Fortier³

et al. 2013

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“…No clear evidence of level III or higher defines the type of GIST for which laparoscopic local gastrectomy is recommended. A retrospective study demonstrated that laparoscopic local gastrectomy can be safely performed if the tumor size is no greater than 5 cm in diameter . Another retrospective study that categorized patients according to tumor size, with a 2 cm diameter being the cut‐off, showed that although extended surgical time and hospitalization were observed in the group of patients with tumors larger than 2 cm, laparoscopic local gastrectomy could be performed safely in both groups, with no postoperative recurrence or metastasis .…”

Section: Clinical Question 3: Is Laparoscopic Local Gastrectomy (K654mentioning

confidence: 99%

Gastroenterological Surgery: Stomach

Uyama

Okabe²,

Kojima³

et al. 2015

Asian J Endoscop Surgery

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“…(7,8) In the meantime, laparoscopic resection with a negative gross margin is oncologically justified for gastric GISTs smaller than 5 cm. (9-13) However, it still remains unknown whether minimally invasive resection of small intestinal GIST is technically and oncologically feasible. To the best of our knowledge, there have been no study evaluating both the technical safety and oncologic feasibility of laparoscopic resection of performed for GISTs of small intestine.…”

Section: Introductionmentioning

confidence: 99%

Treatment Results of Small Intestinal Gastrointestinal Stromal Tumors Less than 10 cm in Diameter: A Comparison between Laparoscopy and Open Surgery

et al. 2012

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PurposeTo evaluate the technical feasibility and oncologic safety, we assessed the short-term and long-term outcomes of laparoscopic resection of the small bowel gastrointestinal stromal tumors smaller than 5 cm by comparing those of open surgery by subgroup analysis based on tumor size.Materials and MethodsFrom November 1993 to January 2011, 41 laparoscopic resections were performed among the 95 patients who underwent resection of small intestine ≤10 cm in diameter. The clinicopathologic features, perioperative outcomes, recurrences and survival of these patients were reviewed.ResultsThe postoperative morbidity rates were comparable between the 2 groups. Laparoscopic surgery group showed significantly shorter operative time (P=0.004) and duration of postoperative hospital stay (P<0.001) than open surgery group and it was more apparent in the smaller tumor size group. There were no difference in 5-year survival for the laparoscopic surgery versus open surgery groups (P=0.163), and in 5-year recurrence-free survival (P=0.262). The subgroup analysis by 5 cm in tumor size also shows no remarkable differences in 5-year survival and recurrence-free survival.ConclusionsLaparoscopic resection for small bowel gastrointestinal stromal tumors of size less than 10 cm has favorable short-term postoperative outcomes, while achieving comparable oncologic results compared with open surgery. Thus, laparoscopic approach can be recommended as a treatment modality for patients with small bowel gastrointestinal stromal tumors less than 10 cm in diameter.

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Long-term Outcomes of Laparoscopic Wedge Resection for Gastrointestinal Stromal Tumors of the Stomach of Less Than 5 cm in Diameter

Abstract: Laparoscopic wedge resection of GISTs of <5 cm in diameter is a safe and oncologically feasible technique offering good long-term outcomes.

Cited by 12 publications

References 19 publications

Oncologic specimen from laparoscopic assisted gastrectomy for gastric adenocarcinoma is comparable to D1-open surgery: the experience of a Canadian centre

Oncologic specimen from laparoscopic assisted gastrectomy for gastric adenocarcinoma is comparable to D1-open surgery: the experience of a Canadian centre

Gastroenterological Surgery: Stomach

Treatment Results of Small Intestinal Gastrointestinal Stromal Tumors Less than 10 cm in Diameter: A Comparison between Laparoscopy and Open Surgery

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