title: Laparoscopic versus open gastric wedge resection for primary gastrointestinal tumors: clinical outcomes and health care costs analysis.
abstract: The study aimed to compare laparoscopic wedge resection (LWR) versus open-wedge resections (OWR) for primary gastrointestinal stromal tumors (GISTs) of the stomach. Twenty-five patients who underwent LWR were matched by tumor size and location with 25 patients who underwent OWR. GISTs close to the pylorus or the esophagogastric junction, incidental, and metastatic GISTs were excluded. Demographic, clinical, and histologic variables did not differ between groups. Estimated blood loss, time to flatus, and duration of hospitalization were significantly lower in the LWR group. Overall, 6 patients developed minor postoperative complications that were medically treated. Mortality was nil. No group difference was observed for the incidence of diseases during the follow-up (average, 46.8 mo). The OWR procedure had significantly higher costs (+34%) than the LWR. Both techniques appear safe and oncologically feasible. However, laparoscopy is associated with faster recovery and shorter hospital stay, which reflect advantages in terms of contracted costs for the health care system.
authors: *Digestive Surgery and Liver Transplant Unit †Unit of Histopathology, Henri-Mondor Hospital, Université Paris Est-Créteil, UPEC ‡Rothschild Hospital, Université Paris 7, Paris, France.
authors: Nicola
authors: N
authors: de'Angelis
authors: Francesco
authors: F
authors: Brunetti
authors: Emanuele
authors: E
authors: Felli
authors: Dalila
authors: D
authors: Mehdaoui
authors: Riccardo
authors: R
authors: Memeo
authors: Maria Clotilde
authors: MC
authors: Carra
authors: Valeria
authors: V
authors: Zuddas
authors: Daniel
authors: D
authors: Azoulay
mesh_terms: D000368:Aged; D003365:Costs and Cost Analysis; D005260:Female; D005500:Follow-Up Studies; D005602:France; D005743:Gastrectomy / Q000191:economics / Q000379:methods*; D046152:Gastrointestinal Stromal Tumors / Q000191:economics / Q000601:surgery*; D017048:Health Care Costs; D006801:Humans; D010535:Laparoscopy / Q000191:economics / Q000379:methods*; D007813:Laparotomy / Q000191:economics / Q000379:methods*; D008297:Male; D008875:Middle Aged; D061646:Operative Time; D012189:Retrospective Studies; D013274:Stomach Neoplasms / Q000191:economics / Q000601:surgery*; D013997:Time Factors; D016896:Treatment Outcome