title: Surgical management of gastrointestinal stromal tumors of the stomach.
abstract: BACKGROUND
  Laparoscopy has emerged as the "gold standard" procedure for many diseases that require surgical treatment. Our goal was to assess the outcomes of laparoscopic vs open partial gastrectomies for the management of gastrointestinal stromal tumors of the stomach (gGIST) using a national database.
  
  
  METHODS
  Using the American College of Surgeons National Surgical Quality Improvement Program (ACS NSQIP) database (2006-2009), we identified patients who underwent laparoscopic and open partial gastrectomy gGIST. Overall morbidity and mortality were assessed. The relationships between anesthesia time, operative duration, surgical site infection (SSI), and hospital stay were also examined. Two-sample t tests were used.
  
  
  RESULTS
  Of 486 patients, 146 (30%) underwent laparoscopic resection (LR) and 340 (70%) underwent open resection (OR). Patients who underwent LP were older (mean: 65 vs 62 years; P = .062). Patients treated with LR experienced shorter anesthesia time (mean: 183 vs 212 minutes; P < .05) and shorter operative time (mean: 119 vs 149 minutes; P < .05) compared with those who underwent OR. All patients treated with LR had fewer SSIs compared with those who underwent OR (0.68% vs 6.7%; P < .001). Patients treated with LR were less likely to experience an overall morbidity (mean: 3.9% vs 11.7%; P < .001) or mortality (mean: 0.23% vs 0.72%; P < .001) and shorter total hospital stay (mean: 3.17 vs 7.50 days; P < .001) compared with those who underwent OR.
  
  
  CONCLUSIONS
  In ACS NSQIP hospitals, laparoscopic resection of gGIST appears to be preferable to open surgery. However, prospective studies with large sample sizes comparing both surgical approaches with size-matched tumors are strongly suggested.
authors.affiliation: Department of General Surgery, New York Hospital Medical Center of Queens/Cornell University Medical College, 5645 Main St, Flushing, NY 1135, USA. omarbellorin@gmail.com.
authors.forename: Omar
authors.initials: O
authors.lastname: Bellorin
authors.affiliation: Department of General Surgery, New York Hospital Medical Center of Queens/Cornell University Medical College, Flushing, NY, USA.
authors.forename: Anna
authors.initials: A
authors.lastname: Kundel
authors.affiliation: Department of General Surgery, New York Hospital Medical Center of Queens/Cornell University Medical College, Flushing, NY, USA.
authors.forename: Mingwei
authors.initials: M
authors.lastname: Ni
authors.affiliation: Department of General Surgery, New York Hospital Medical Center of Queens/Cornell University Medical College, Flushing, NY, USA.
authors.forename: Du
authors.initials: D
authors.lastname: Litong
mesh_terms: D000368:Aged; D005260:Female; D005500:Follow-Up Studies; D005743:Gastrectomy / Q000379:methods*; D046152:Gastrointestinal Stromal Tumors / Q000175:diagnosis / Q000601:surgery*; D006801:Humans; D010535:Laparoscopy / Q000379:methods*; D008297:Male; D008875:Middle Aged; D009017:Morbidity / Q000639:trends; D009518:New York / Q000453:epidemiology; D011183:Postoperative Complications / Q000453:epidemiology; D012189:Retrospective Studies; D013270:Stomach / Q000473:pathology / Q000601:surgery*; D013274:Stomach Neoplasms / Q000175:diagnosis / Q000601:surgery*; D015996:Survival Rate / Q000639:trends; D016896:Treatment Outcome