title: Laparoscopic resection of gastrointestinal stromal tumors: safe, efficient, and comparable oncologic outcomes.
abstract: BACKGROUND
  Surgery of gastrointestinal stromal tumors (GISTs) has been modified, and laparoscopic resection of GIST has gained improvement and roles.
  
  
  METHODS
  We retrospectively reviewed clinical data and oncological outcomes of our GIST patients who underwent laparoscopic surgery and traditional open surgery. In total, 227 pathologically diagnosed GIST cases were retrospectively reviewed in Chang Gung Memorial Hospital at Linkou, Taipei, Taiwan, between 2005 and 2010. We excluded those with tumor size >5 cm, biopsy-only, combined other operation, endoscopic mucosal resection, tumor located in the duodenum, colon-rectum, esophagocardiac junction, omentum, pelvic area, or retroperitoneum, or metastasis when operated on and those diagnosed as other disease after immunohistologic examination of GIST. Fifty-eight cases were enrolled, including 16 patients in the laparoscopic surgery group (LSG) and 42 patients in the open surgery group (OSG). The patients' demography, perioperative, pathologic result, and oncology result were recorded and analyzed.
  
  
  RESULTS
  Both groups showed no difference in clinical demography, tumor size, and locations. LSG patients showed fewer days to resume diet, shorter postoperative hospital stays, and less use of patient-controlled analgesia. The postoperative morbidity in LSG and OSG was 6.3% and 19%, respectively. The median follow-up time was 32.73 months in LSG and 39.75 months in OSG. Recurrence or metastasis was observed in 3 patients (1 in LSG and 2 in OSG). The recurrence rate between LSG and OSG showed no significant difference.
  
  
  CONCLUSIONS
  Laparoscopic surgery was technically feasible for GIST of no more than 5 cm located at the stomach and small bowel. In the current study, we demonstrated that LSG patients benefited from fewer days to resume diet (5 versus 5.71 days), shorter postoperative stays (8 versus 9.07 days), and less patient-controlled analgesia use (6.7% versus 90.9%) during the perioperative period with the same short-term oncology result compared with OSG patients.
authors.affiliation: Department of Surgery, Chang Gung Memorial Hospital at Linkou, Chang Gung University, Taipei, Taiwan.
authors.forename: Yu-Hsien
authors.initials: YH
authors.lastname: Chen
authors.forename: Keng-Hao
authors.initials: KH
authors.lastname: Liu
authors.forename: Chun-Nan
authors.initials: CN
authors.lastname: Yeh
authors.forename: Jun-Te
authors.initials: JT
authors.lastname: Hsu
authors.forename: Yu-Yin
authors.initials: YY
authors.lastname: Liu
authors.forename: Chun-Yi
authors.initials: CY
authors.lastname: Tsai
authors.forename: Cheng-Tang
authors.initials: CT
authors.lastname: Chiu
authors.forename: Yi-Yin
authors.initials: YY
authors.lastname: Jan
authors.forename: Ta-Sen
authors.initials: TS
authors.lastname: Yeh
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D016058:Analgesia, Patient-Controlled / Q000706:statistics & numerical data; D013505:Digestive System Surgical Procedures / Q000379:methods*; D005260:Female; D005770:Gastrointestinal Neoplasms / Q000601:surgery*; D046152:Gastrointestinal Stromal Tumors / Q000601:surgery*; D006801:Humans; D010535:Laparoscopy; D008297:Male; D008875:Middle Aged; D016896:Treatment Outcome