Safety and efficacy of laparoscopic wedge gastrectomy for large gastrointestinal stromal tumors

Eur J Surg Oncol. 2017 Apr;43(4):796-800. doi: 10.1016/j.ejso.2017.01.005. Epub 2017 Jan 18.


Background: Although the feasibility of minimally invasive resection of small gastric GISTs is well established, less is known about safety and efficacy of laparoscopic surgery for large tumors.

Methods: A retrospective analysis was performed, using a prospectively maintained comprehensive database. Patients were divided into two groups according to tumor size: Case group with tumors > 5 cm and control group with tumors <5 cm. Hospital charts were reviewed, and various outcome measures recorded, including operative time, estimated operative blood loss, post-operative leak, stasis, infection and recurrence.

Results: No tumors were ruptured during surgical manipulation and no major morbidity or mortality occurred in either group. Operative time (75,8 ± 33,1 min in large cases vs 75,8 ± 33,1 min in small cases) was similar in both groups (p = 0,61). The incidence of post-operative complications did not differ between the two groups. In details there were 21 out of 25 (84%) uncomplicated cases among small GISTs versus 17 out of 24 (70,8%) uncomplicated cases among large GISTs (p = 0,32).

Conclusion: This matched-pair case control study demonstrates that laparoscopic wedge resection for large gastric GISTs is safe and effective, as demonstrated for small tumors.

Keywords: GIST; Gastrectomy; Gastrointestinal stromal tumor; Laparoscopic; Wedge gastrectomy.

MeSH terms

  • Aged
  • Aged, 80 and over
  • Blood Loss, Surgical / statistics & numerical data
  • Case-Control Studies
  • Databases, Factual
  • Female
  • Gastrectomy / methods*
  • Gastrointestinal Stromal Tumors / pathology
  • Gastrointestinal Stromal Tumors / surgery*
  • Humans
  • Incidence
  • Infections / epidemiology
  • Laparoscopy
  • Male
  • Middle Aged
  • Neoplasm Recurrence, Local / epidemiology*
  • Operative Time
  • Postoperative Complications / epidemiology*
  • Retrospective Studies
  • Stomach Neoplasms / pathology
  • Stomach Neoplasms / surgery*
  • Tumor Burden