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Laparoscopic versus open resection of gastrointestinal stromal tumors of the stomach

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Abstract

Background

Gastrointestinal stromal tumors (GISTs) are the most common mesenchymal tumors of the gastrointestinal tract. Surgical treatment is the only chance of cure for patients with a primary localized GIST. A laparoscopic approach has been considered reasonable for these tumors of gastric origin. The current study compares the outcome of laparoscopic versus open resection of gastric GISTs and compares our series with the few published studies comparing the open versus the laparoscopic approach.

Methods

From a prospectively collected database, we found 53 primary gastric GIST resections that were performed in our department. Laparoscopic (LAP) resections were performed in 37 patients and traditional (OPEN) resections in 16 patients. Clinical and pathologic characteristics and surgical outcomes were analyzed according to surgical procedure.

Results

Patients who underwent LAP or OPEN resection of gastric GISTs did not differ with respect to age at operation, gender, clinical presentation, and tumor size. Operative time was significantly lower for LAP than for OPEN resection, with a mean duration of 45 and 132.5 min, respectively (p < 0.001). LAP resection yielded a significantly shorter length of stay (median 7 vs. 14 days; p = 0.007) and lower 30-day morbidity rate (2.7 % vs. 18.9 %; p = 0.077). The operative mortality was 12.5 % after OPEN resection and there was no operative mortality after LAP (p = 0.087). The recurrence rate was significantly lower after LAP surgery (0 % vs. 37.5 %; p < 0.001). All patients in the LAP group are alive without recurrence, and 25 % (4/16) of the OPEN group are alive with recurrence but in complete remission under imatinib mesylate treatment. Two patients of the open group died due to progression of GIST (p = 0.087).

Conclusions

Compared to open resection, laparoscopic resection of gastric stromal tumors is associated with a shorter operation time, a shorter hospital stay, and a lower recurrence rate.

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Disclosures

Drs. De Vogelaere, Hoorens, Haentjens, and Delvaux have no commercial association that might create a conflict of interest in connection with any of the products mentioned in this article.

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Authors and Affiliations

  1. Department of Abdominal Surgery, UZ Brussel, Jette, Belgium

    Kristel De Vogelaere, Patrick Haentjens & Georges Delvaux

  2. Department of Pathology, UZ Brussel, Jette, Belgium

    Anne Hoorens

  3. Department of Surgery, UZ Brussel, Laarbeeklaan 101, 1090, Jette, Belgium

    Kristel De Vogelaere

Authors
  1. Kristel De Vogelaere
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  2. Anne Hoorens
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  3. Patrick Haentjens
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  4. Georges Delvaux
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Correspondence to Kristel De Vogelaere.

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De Vogelaere, K., Hoorens, A., Haentjens, P. et al. Laparoscopic versus open resection of gastrointestinal stromal tumors of the stomach. Surg Endosc 27, 1546–1554 (2013). https://doi.org/10.1007/s00464-012-2622-8

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  • DOI: https://doi.org/10.1007/s00464-012-2622-8

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