title: [Clinical efficacy comparison between laparoscopic and open surgery in the treatment of gastric gastrointestinal stromal tumor].
abstract: OBJECTIVE
  To compare the efficacy between laparoscopic and open surgery in the treatment of gastric gastrointestinal stromal tumor (gastric GIST), and to explore the feasibility and safety of laparoscopic resection for gastric GIST.
  
  
  METHODS
  Clinical data of 226 gastric GIST patients confirmed by pathology with maximal tumor diameter less than 10 cm undergoing operation in our department from January 2002 to December 2013 were retrospectively analyzed. Among them, 158 patients received laparoscopic surgery(laparoscopic group), and 68 open surgery (open group). Related indicators of clinical efficacy were compared between the two groups. Laparoscopic group patients were further divided into 4 groups according to chronological order, including 39 patients in group A, 39 in group B, 39 in group C and 41 in group D. Operating time was compared among 4 groups.
  
  
  RESULTS
  Compared with the open group, laparoscopic group had shorter operation time [(138.8±69.2) min vs. (173.3±74.5) min, P=0.001], less intraoperative bleeding [30 ml vs. 125 ml, P=0.000], faster recovery to postoperative first flatus [(3.2±1.1) d vs. (3.8±1.1) d, P=0.000] and resumption of oral intake [(3.9±1.5) d vs. (4.7±1.5) d, P=0.000], and a shorter hospital stay [(8.1±2.3) d vs. (10.0±2.6) d, P=0.001]. The operation time of laparoscopic group A, B, C and D was (181.0±81.2) min, (124.7±57.8) min, (126.9±67.9) min and (123.4±51.8) min respectively, and the difference was statistically significant(F=7.188, P=0.001). Median follow-up time of 226 patients was 32 months(5 to 104 months). In laparoscopic group, 136 cases(86.1%) received follow-up, and the 1-, 3-, and 5-year overall survival were 98.7%, 90.7% and 72.8% respectively. In the open group, 59 cases (86.8%) received follow-up, and the 1-, 3-, and 5-year overall survival were 98.3%, 87.1% and 83.1%, respectively. The survival between two groups were not significantly different(P=0.164).
  
  
  CONCLUSIONS
  Laparoscopic surgery removing gastric GIST with a maximal diameter of less than 10 cm is safe and feasible. The learning curve of laparoscopic gastric GIST surgery is about 40 cases.
authors: Department of General Surgery, Center of Minimal Invasive Gastrointestinal Surgery, Southwest Hospital, The Third Military Medical University, Chongqing 400038, China. 506038746@qq.com.
authors: Peng
authors: P
authors: Yan
authors: Jiajia
authors: J
authors: Liu
authors: Xin
authors: X
authors: Hu
authors: Junyan
authors: J
authors: Liu
authors: Yixi
authors: Y
authors: Wu
authors: Yongliang
authors: Y
authors: Zhao
authors: Peiwu
authors: P
authors: Yu
authors: Feng
authors: F
authors: Qian
mesh_terms: D005743:Gastrectomy; D005770:Gastrointestinal Neoplasms; D046152:Gastrointestinal Stromal Tumors; D006801:Humans; D010535:Laparoscopy; D007902:Length of Stay; D061646:Operative Time; D011184:Postoperative Period; D012189:Retrospective Studies; D012449:Safety