title: Choices of surgical approaches for gastrointestinal stromal tumors of the stomach: laparoscopic versus open resection.
abstract: OBJECTIVE
  The aim of this study is to explore the optimal surgical approach for gastrointestinal stromal tumors (GISTs) of the stomach in terms of the perioperative outcomes and long-term relapse-free survival.
  
  
  METHODS
  From January 2004 to July 2011, 156 patients who underwent either laparoscopic (LAP group, n = 68) or open surgery (OPEN group, n = 88) were included in the final analysis following the eligibility criteria.
  
  
  RESULTS
  Clinicopathological characteristics of the selected patients were similar between the two groups. The LAP group was associated with less blood loss (50 vs. 180 ml, p < 0.001), shorter operating time (90 vs. 125 min, p < 0.001), earlier oral intake (3 vs. 5 days, p < 0.001), shorter postoperative hospital stay (8 vs. 10 days, p < 0.001), and low risk of postoperative complications (5.9 vs. 22.7%, p = 0.004) compared with the OPEN group. No significant difference was observed in 5-year relapse-free survival between the LAP and OPEN groups (94.2 vs. 94.0%, p = 0.807). The subgroup analysis of patients who underwent wedge resection showed similar results with the original comparison except that difference in complication rate between the two groups lost significance.
  
  
  CONCLUSIONS
  Laparoscopic wedge resection for gastric GISTs ≤ 7 cm could get preferable short-term postoperative outcomes and similar long-term relapse-free survival compared with open surgery.
authors: Department of Surgery, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
authors: Ping
authors: P
authors: Wan
authors: Chao
authors: C
authors: Yan
authors: Chen
authors: C
authors: Li
authors: Min
authors: M
authors: Yan
authors: Zheng Gang
authors: ZG
authors: Zhu
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000970:Antineoplastic Agents / Q000627:therapeutic use; D001549:Benzamides; D016063:Blood Loss, Surgical; D001810:Blood Volume; D017024:Chemotherapy, Adjuvant; D018572:Disease-Free Survival; D005260:Female; D005743:Gastrectomy / Q000009:adverse effects / Q000379:methods; D046152:Gastrointestinal Stromal Tumors / Q000188:drug therapy / Q000473:pathology / Q000601:surgery*; D006801:Humans; D000068877:Imatinib Mesylate; D053208:Kaplan-Meier Estimate; D010535:Laparoscopy / Q000009:adverse effects / Q000379:methods; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D061646:Operative Time; D010879:Piperazines / Q000627:therapeutic use; D011743:Pyrimidines / Q000627:therapeutic use; D013274:Stomach Neoplasms / Q000188:drug therapy / Q000473:pathology / Q000601:surgery*; D055815:Young Adult
chemical_list: D000970:Antineoplastic Agents; D001549:Benzamides; D010879:Piperazines; D011743:Pyrimidines; D000068877:Imatinib Mesylate