title: Laparoscopic wedge resection for suspected large (≥5 cm) gastric gastrointestinal stromal tumors.
abstract: Laparoscopic wedge resection (LWR) for small gastric gastrointestinal stromal tumors (GIST) is now widely accepted, but its application for large GISTs remains controversial. This study aims to evaluate the feasibility and safety of LWR for suspected large (≥5 cm) gastric GISTs.
  
  
  
  Retrospective review of 82 consecutive patients who underwent attempted LWR for suspected gastric GIST. LWR for large (≥5 cm) (n = 23) tumors was compared with LWR for small (<5 cm) tumors (n = 59). The 23 patients with LWR for large tumors were also compared to 36 consecutive patients who underwent open wedge resection (OWR) for large tumors.
  
  
  
  Comparison between patients who underwent LWR for large versus small tumors demonstrated that resection of large tumors was associated with a longer operating time. There was no difference in other perioperative outcomes, and oncological outcomes such as frequency of close margins (≤1 mm) and recurrence-free survival. Comparison between patients who underwent LWR versus OWR for large tumors showed that LWR was associated with decreased median time to fluid or solid diet, shorter postoperative stay but longer operating times. There was no difference in oncological outcomes.
  
  
  
  LWR for suspected large gastric GIST is feasible and safe. It is associated with similar short-term outcomes with LWR for small tumors and favorable short-term outcomes over OWR for large tumors without compromising on oncological outcomes.
authors.affiliation: Department of Hepatopancreatobiliary and Transplantation Surgery, Singapore General Hospital, 20 College Road, Academia Level 5, Singapore, 169856, Singapore.|Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore.
authors.forename: Chun Yuet
authors.initials: CY
authors.lastname: Khoo
authors.affiliation: Department of Hepatopancreatobiliary and Transplantation Surgery, Singapore General Hospital, 20 College Road, Academia Level 5, Singapore, 169856, Singapore. bsgkp@hotmail.com.|Duke-National University of Singapore Medical School, Singapore, Singapore. bsgkp@hotmail.com.
authors.forename: Brian K P
authors.initials: BKP
authors.lastname: Goh
authors.affiliation: Department of Upper Gastrointestinal and Bariatric Surgery, Singapore General Hospital, Singapore, Singapore.
authors.forename: Alvin K H
authors.initials: AKH
authors.lastname: Eng
authors.affiliation: Department of Upper Gastrointestinal and Bariatric Surgery, Singapore General Hospital, Singapore, Singapore.
authors.forename: Weng-Hoong
authors.initials: WH
authors.lastname: Chan
authors.affiliation: Division of Surgical Oncology, National Cancer Center Singapore, Singapore, Singapore.
authors.forename: Melissa C C
authors.initials: MCC
authors.lastname: Teo
authors.affiliation: Department of Hepatopancreatobiliary and Transplantation Surgery, Singapore General Hospital, 20 College Road, Academia Level 5, Singapore, 169856, Singapore.
authors.forename: Alexander Y F
authors.initials: AYF
authors.lastname: Chung
authors.affiliation: Department of Upper Gastrointestinal and Bariatric Surgery, Singapore General Hospital, Singapore, Singapore.
authors.forename: Hock-Soo
authors.initials: HS
authors.lastname: Ong
authors.affiliation: Department of Upper Gastrointestinal and Bariatric Surgery, Singapore General Hospital, Singapore, Singapore.
authors.forename: Wai-Keong
authors.initials: WK
authors.lastname: Wong
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005240:Feasibility Studies; D005260:Female; D005743:Gastrectomy / Q000379:methods*; D046152:Gastrointestinal Stromal Tumors / Q000473:pathology / Q000601:surgery*; D006801:Humans; D010535:Laparoscopy / Q000379:methods*; D008297:Male; D008875:Middle Aged; D061646:Operative Time; D011184:Postoperative Period; D012189:Retrospective Studies; D013274:Stomach Neoplasms / Q000473:pathology / Q000601:surgery*
keywords: Gastrointestinal stromal tumors; Laparoscopic resection; Laparoscopy; Large; Wedge resection