Laparoscopic versus open resection of gastric gastrointestinal stromal tumors Journal Article

Authors: Melstrom, L. G.; Phillips, J. D.; Bentrem, D. J.; Wayne, J. D.
Article Title: Laparoscopic versus open resection of gastric gastrointestinal stromal tumors
Abstract: OBJECTIVES: Gastrointestinal stromal tumors (GISTs) are the most common mesenchymal tumors of the gastrointestinal tract. There is some controversy as to the effectiveness and feasibility of laparoscopic versus open resection of these tumors. We hypothesized that laparoscopic resection of gastric GISTs would offer better perioperative outcomes compared with the traditional open approach. METHODS: A retrospective review was conducted of all GISTs treated at a tertiary care urban teaching hospital between January 1999 and August 2008. The medical records were examined for demographic and clinicopathological features. RESULTS: Forty-six gastric GISTs were identified (17 treated laparoscopically and 29 treated via laparotomy). The median age of patients in these groups were comparable at 62 and 60, respectively. Body mass index of these patients were also similar at 28.2 kg/m for the laparoscopic and 29.9 kg/m for the open group. The average size of tumor was slightly smaller in the laparoscopic group at 4.27 cm versus the open group at 6.39 cm (NS). The estimated blood loss for the laparoscopic group was lower at 94 mL versus 169 mL (P = 0.059). Operative times for the 2 surgical approaches were not significantly different at 135 minutes for laparoscopic and 157.4 minutes for open. Laparoscopic resection yielded a significantly shorter length of stay compared with open at 2.68 versus 6.25 days (P < 0.001). CONCLUSIONS: Laparoscopic resection of gastric GISTs offers a decreased length of stay, a trend to decreased blood loss, and comparable oncologic outcomes indicating that a laparoscopic approach should be considered in all patients with gastric GISTs who do not have a contraindication to this approach. Copyright © 2011 by Lippincott Williams & Wilkins.
Keywords: adult; clinical article; controlled study; treatment outcome; middle aged; retrospective studies; follow-up studies; laparoscopy; laparoscopic surgery; laparotomy; prospective studies; gastrointestinal stromal tumor; stem cell factor receptor; gastrointestinal stromal tumors; deep vein thrombosis; medical record review; length of stay; body mass; operation duration; surgical infection; gastrectomy; intermethod comparison; gist; postoperative hemorrhage; stomach neoplasms; abdominal wall hernia; total stomach resection; incisional hernia; wedge resection; gastrointestinal tumors; operative time
Journal Title: American Journal of Clinical Oncology: Cancer Clinical Trials
Volume: 35
Issue: 5
ISSN: 0277-3732
Publisher: Lippincott Williams & Wilkins  
Date Published: 2012-10-01
Start Page: 451
End Page: 454
Language: English
DOI: 10.1097/COC.0b013e31821954a7
PROVIDER: scopus
PUBMED: 21552096
Notes: --- - "Export Date: 2 November 2012" - "CODEN: AJCOD" - "Source: Scopus"
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