title: Surgical strategy for the gastric gastrointestinal stromal tumors (GISTs) larger than 5 cm: laparoscopic surgery is feasible, safe, and oncologically acceptable.
abstract: BACKGROUND
  The efficacy and feasibility of laparoscopic surgery (LAP) for gastric GISTs >5 cm has not been adequately assessed. Here we investigated the clinical outcomes of these patients.
  
  
  METHODS
  Twenty-seven consecutive patients who underwent resection for gastric GISTs >5 cm were enrolled in this retrospective study. We assessed the tumor characteristics, surgical outcomes, tumor recurrence, and patient survival in the open surgery (OPEN) group and in the LAP group.
  
  
  RESULTS
  The tumor size in the OPEN group was larger than that in the LAP group, but there were no differences in the mitotic count. There were no differences in operative complications. Finally, there were no differences in the disease-free and no patients in the LAP group died.
  
  
  CONCLUSIONS
  In patients with gastric GISTs >5 cm, LAP can be performed with outcomes equivalent to those of OPEN if patient selection and intraoperative judgment are appropriate.
authors.affiliation: *Department of Surgery, Osaka University Graduate School of Medicine, Suita †Department of Surgery, Osaka Police Hospital, Osaka, Japan.
authors.forename: Tsuyoshi
authors.initials: T
authors.lastname: Takahashi
authors.forename: Kiyokazu
authors.initials: K
authors.lastname: Nakajima
authors.forename: Yasuaki
authors.initials: Y
authors.lastname: Miyazaki
authors.forename: Yasuhiro
authors.initials: Y
authors.lastname: Miyazaki
authors.forename: Yukinori
authors.initials: Y
authors.lastname: Kurokawa
authors.forename: Makoto
authors.initials: M
authors.lastname: Yamasaki
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Miyata
authors.forename: Shuji
authors.initials: S
authors.lastname: Takiguchi
authors.forename: Toshirou
authors.initials: T
authors.lastname: Nishida
authors.forename: Masaki
authors.initials: M
authors.lastname: Mori
authors.forename: Yuichiro
authors.initials: Y
authors.lastname: Doki
mesh_terms: D000293:Adolescent; D000328:Adult; D005240:Feasibility Studies; D005743:Gastrectomy / Q000379:methods / Q000592:standards*; D046152:Gastrointestinal Stromal Tumors / Q000175:diagnosis / Q000601:surgery*; D006801:Humans; D010535:Laparoscopy / Q000379:methods / Q000592:standards*; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D017410:Practice Guidelines as Topic; D012189:Retrospective Studies; D013274:Stomach Neoplasms / Q000175:diagnosis / Q000601:surgery*; D016896:Treatment Outcome; D055815:Young Adult