title: Laparoscopic Versus Open Resection for Gastrointestinal Stromal Tumors (GISTs).
abstract: OBJECTIVE
  Primary gastrointestinal stromal tumors (GISTs) are typically treated with open resection. There is growing interest in laparoscopic GIST resection; however, data is limited. We report our experience with GIST resections using both open and laparoscopic techniques.
  
  
  METHODS
  Twenty-nine GIST patients underwent definitive intent resection at the University of Missouri from 1990 to 2010. Patients who underwent laparoscopic resection (n = 7) were matched on the basis of tumor size, age, tumor location, and National Comprehensive Cancer Network (NCCN) risk stratification with seven patients who underwent open resection. The two groups were compared with respect to age, gender, BMI, tumor size, tumor site, mitotic rate, surgical margins, NCCN risk stratification, estimated blood loss, hospital stay, surgical complications, disease recurrence, and overall survival.
  
  
  RESULTS
  The cohorts did not differ with respect to age, gender, BMI, tumor location, tumor size, or positive margins (p > 0.05). Patients who underwent open resection had more NCCN high-risk patients, but the difference was not statistically significant (p = 0.08). There was significantly less estimated blood loss (median 15 vs. 150 mL, p < 0.05) and significantly shorter hospital stay (median 4 vs. 7 days, p < 0.05) for the laparoscopy group. There were no recurrences in the laparoscopy group, but there was one in the open group with a median follow-up of 55 and 63 months, respectively (p > 0.05). Five-year disease-free survival was 100 % for the laparoscopic group and 83 % for the open resection group.
  
  
  CONCLUSIONS
  Laparoscopic resection for appropriately selected GISTs is feasible and associated with significantly less blood loss and shorter hospitalizations compared to open resection. Further studies are needed to better define its role for GIST.
authors: Department of Surgery, University of Missouri School of Medicine, Columbia, MO, 65212, USA.|Department of Dermatology, Johns Hopkins Hospital, Baltimore, MD, 21287, USA.
authors: Kelly M
authors: KM
authors: MacArthur
authors: Department of Radiation Oncology, Hospital of the University of Pennsylvania, Philadelphia, PA, 19104, USA.
authors: Brian C
authors: BC
authors: Baumann
authors: Department of Surgery, University of Missouri School of Medicine, Columbia, MO, 65212, USA. michaelnicholl@gmail.com.|South Texas Veterans Health Care System, 7400 Merton Minter Blvd, San Antonio, TX, 78229, USA. michaelnicholl@gmail.com.
authors: Michael B
authors: MB
authors: Nicholl
mesh_terms: D000368:Aged; D005260:Female; D005743:Gastrectomy / Q000379:methods; D005770:Gastrointestinal Neoplasms / Q000473:pathology / Q000601:surgery*; D046152:Gastrointestinal Stromal Tumors / Q000473:pathology / Q000601:surgery*; D006801:Humans; D010535:Laparoscopy / Q000379:methods; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D016896:Treatment Outcome
keywords: Cancer; Gastrointestinal stromal tumor; Laparoscopy; Surgery