title: Usefulness of laparoscopic side-to-side duodenojejunostomy for gastrointestinal stromal tumors located at the duodenojejunal junction.
abstract: BACKGROUND
  Surgery for gastrointestinal stromal tumor (GIST) at the duodenojejunal junction is a technically challenging and difficult procedure because of the anatomical complexity. When it comes to laparoscopic surgery, it is more challenging than open surgery. This study aimed to introduce our laparoscopic procedure and to evaluate its clinical implication by comparing with open procedures.
  
  
  METHODS
  Between 2003 and 2013, 19 patients underwent segmental resection for a GIST at the duodenojejunal junction: laparoscopic segmental resection with side-to-side duodenojejunostomy (n = 8) and open surgery (n = 11). Clinicopathological findings, operation details, and postoperative outcomes were compared.
  
  
  RESULTS
  Both groups were comparable in demographics and clinicopathological characteristics. Postoperative hospital stay of the laparoscopic group (6.3 days) was significantly shorter than the open group (15.7 days, P = 0.008) while no significant differences were observed regarding estimated blood loss, operation time, and morbidity. All patients in both groups underwent curative resection without operative mortality. Two patients experienced recurrence after open surgery whereas none of the patients after laparoscopic duodenojejunostomy had recurrence with a median follow-up period of 36 months.
  
  
  CONCLUSIONS
  Laparoscopic segmental resection with side-to-side duodenojejunostomy for a GIST at the duodenojejunal junction is a safe, feasible, and effective alternative to open approach, providing benefits of minimally invasive surgery.
authors.affiliation: Department of Surgery, Yonsei University College of Medicine, 50-1 Yonsei-ro Seodaemun-gu, Seoul, 120-752, South Korea.
authors.forename: Eiji
authors.initials: E
authors.lastname: Tanaka
authors.forename: Minjhi
authors.initials: M
authors.lastname: Kim
authors.forename: Joon Seok
authors.initials: JS
authors.lastname: Lim
authors.forename: Yoon Young
authors.initials: YY
authors.lastname: Choi
authors.forename: Avanish
authors.initials: A
authors.lastname: Saklani
authors.forename: Sung Hoon
authors.initials: SH
authors.lastname: Noh
authors.forename: Woo Jin
authors.initials: WJ
authors.lastname: Hyung
mesh_terms: D000328:Adult; D000368:Aged; D000714:Anastomosis, Surgical / Q000009:adverse effects / Q000379:methods; D016063:Blood Loss, Surgical; D004379:Duodenal Neoplasms / Q000601:surgery*; D004386:Duodenum / Q000601:surgery*; D005260:Female; D046152:Gastrointestinal Stromal Tumors / Q000601:surgery*; D006801:Humans; D007580:Jejunal Neoplasms / Q000601:surgery*; D007583:Jejunum / Q000601:surgery*; D010535:Laparoscopy / Q000009:adverse effects / Q000379:methods*; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000209:etiology*; D061646:Operative Time; D016896:Treatment Outcome