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

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 postoperative 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. (C) 2017 Elsevier Ltd, BASO - The Association for Cancer Surgery, and the European Society of Surgical Oncology. All rights reserved.