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Laparoscopic wedge resection for suspected large (≥5 cm) gastric gastrointestinal stromal tumors

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Abstract

Background

Laparoscopic wedge resection (LWR) for small gastric gastrointestinal stromal tumors (GIST) is now widely accepted, but its application for large GISTs remains controversial. This study aims to evaluate the feasibility and safety of LWR for suspected large (≥5 cm) gastric GISTs.

Methods

Retrospective review of 82 consecutive patients who underwent attempted LWR for suspected gastric GIST. LWR for large (≥5 cm) (n = 23) tumors was compared with LWR for small (<5 cm) tumors (n = 59). The 23 patients with LWR for large tumors were also compared to 36 consecutive patients who underwent open wedge resection (OWR) for large tumors.

Results

Comparison between patients who underwent LWR for large versus small tumors demonstrated that resection of large tumors was associated with a longer operating time. There was no difference in other perioperative outcomes, and oncological outcomes such as frequency of close margins (≤1 mm) and recurrence-free survival. Comparison between patients who underwent LWR versus OWR for large tumors showed that LWR was associated with decreased median time to fluid or solid diet, shorter postoperative stay but longer operating times. There was no difference in oncological outcomes.

Conclusion

LWR for suspected large gastric GIST is feasible and safe. It is associated with similar short-term outcomes with LWR for small tumors and favorable short-term outcomes over OWR for large tumors without compromising on oncological outcomes.

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Authors and Affiliations

  1. Department of Hepatopancreatobiliary and Transplantation Surgery, Singapore General Hospital, 20 College Road, Academia Level 5, Singapore, 169856, Singapore

    Chun Yuet Khoo, Brian K. P. Goh & Alexander Y. F. Chung

  2. Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore

    Chun Yuet Khoo

  3. Duke-National University of Singapore Medical School, Singapore, Singapore

    Brian K. P. Goh

  4. Department of Upper Gastrointestinal and Bariatric Surgery, Singapore General Hospital, Singapore, Singapore

    Alvin K. H. Eng, Weng-Hoong Chan, Hock-Soo Ong & Wai-Keong Wong

  5. Division of Surgical Oncology, National Cancer Center Singapore, Singapore, Singapore

    Melissa C. C. Teo

Authors
  1. Chun Yuet Khoo
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  2. Brian K. P. Goh
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  3. Alvin K. H. Eng
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  4. Weng-Hoong Chan
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  5. Melissa C. C. Teo
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  6. Alexander Y. F. Chung
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  7. Hock-Soo Ong
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  8. Wai-Keong Wong
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Correspondence to Brian K. P. Goh.

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Disclosures

Chun Yuet Khoo, Brian K. P. Goh, Alvin K. H. Eng, Weng-Hoong Chan, Melissa C. C. Teo, Alexander Y. F. Chung, Hock-Soo Ong, and Wai-Keong Wong have no conflicts of interest or financial ties to disclose.

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Khoo, C.Y., Goh, B.K.P., Eng, A.K.H. et al. Laparoscopic wedge resection for suspected large (≥5 cm) gastric gastrointestinal stromal tumors. Surg Endosc 31, 2271–2279 (2017). https://doi.org/10.1007/s00464-016-5229-7

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  • DOI: https://doi.org/10.1007/s00464-016-5229-7

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