Laparoscopic wedge resection for gastric submucosal tumors: a size-location matched case-control study

J Am Coll Surg. 2011 Feb;212(2):195-9. doi: 10.1016/j.jamcollsurg.2010.10.008. Epub 2010 Dec 13.

Abstract

Background: Laparoscopic local resection for gastric submucosal tumors (SMTs) has become accepted as a standard treatment because it offers less postoperative pain and faster recovery. However, until recently, the laparoscopic approach has been limited by tumor location and size. The aim of this study was to examine the efficacy and safety of laparoscopic wedge resection (LWR) in comparison to open wedge resection (OWR), based on tumor size and location.

Study design: In this case-control study, 50 patients who received LWR for gastric SMTs were carefully matched by size and location of the tumor; 50 patients underwent OWR during the same period. Patient demographics, clinicopathologic characteristics, and postoperative courses were compared.

Results: After matching for tumor size and location, the LWR group showed more favorable results than the OWR group in terms of the starting time of soft meals (mean days, 3.4 vs 4.8, respectively; p < 0.001) and length of hospital stay (mean days, 5.7 vs 7.8, respectively; p < 0.001), but not in terms of operative time (mean minutes, 153 vs 127, respectively; p < 0.05). The rate of postoperative complications did not differ between the groups.

Conclusions: This case-control study suggests that laparoscopic surgery can be safely performed for gastric SMTs and results in a better postoperative recovery, regardless of tumor size or location.

MeSH terms

  • Adult
  • Aged
  • Case-Control Studies
  • Female
  • Gastrectomy / adverse effects
  • Gastrectomy / methods*
  • Gastric Mucosa / pathology*
  • Gastric Mucosa / surgery*
  • Humans
  • Laparoscopy* / adverse effects
  • Length of Stay
  • Male
  • Medical Records
  • Middle Aged
  • Prospective Studies
  • Stomach Neoplasms / pathology*
  • Stomach Neoplasms / surgery*
  • Treatment Outcome