Long-term and surgical outcomes of laparoscopic surgery for gastric gastrointestinal stromal tumors.

BACKGROUND

Gastrointestinal stromal tumors (GISTs) are the most common mesenchymal neoplasms of the gastrointestinal tract. Surgical resection with a free margin is the gold standard treatment for these lesions.

OBJECTIVE

The aim of this study was to evaluate the feasibility of performing laparoscopic resection for gastric GIST from the viewpoint of operative and long-term oncological outcomes.

METHODS

Between 2005 and 2011, a total of 78 consecutive patients undergoing laparoscopic resection of gastric GISTs were enrolled in a retrospective single-center study. Patient and tumor characteristics, surgical procedures, risk classification, postoperative complications, mortality, recurrence, and survival time were collected from a database, and the descriptive statistics were estimated.

RESULTS

Patients (N = 78; 32 males and 46 females) with a median age of 63 years (range 31-82) were evaluated. The tumors were located at the cardia (10.3%), upper stomach (59.0%), middle stomach (23.1), and lower stomach (7.7%). The mean size of the tumors was 34.7 ± 12.1 mm. The laparoscopic procedures included wedge resection (92.3%), such as laparoscopy and endoscopy cooperative surgery (51.3%), and gastrectomy (7.7%). All cases exhibited a pathologically negative margin. The mean operative time was 147.5 ± 63.8 min, and the mean estimated amount of blood loss was 17.8 ± 47.9 ml. The mean length of hospitalization was 9.4 ± 12.8 days. The incidence of perioperative complications higher than grade III was 2.6%, including two cases of anastomotic leakage. Regarding risk classification, low, intermediate and high were observed in 61, 6, and 11 cases, respectively. During a mean follow-up period of 45.3 ± 18.5 months, one patient experienced local recurrence in the omentum. Meanwhile, four patients died due to other diseases; all other patients survived.

CONCLUSIONS

Adequate oncologic resection was achieved in all cases. Laparoscopic surgery is a feasible option for gastric GISTs <5 cm.