title: Safety and efficacy of laparoscopic wedge gastrectomy for large gastrointestinal stromal tumors.
abstract: BACKGROUND
  Although the feasibility of minimally invasive resection of small gastric GISTs is well established, less is known about safety and efficacy of laparoscopic surgery for large tumors.
  
  
  METHODS
  A retrospective analysis was performed, using a prospectively maintained comprehensive database. Patients were divided into two groups according to tumor size: Case group with tumors > 5 cm and control group with tumors <5 cm. Hospital charts were reviewed, and various outcome measures recorded, including operative time, estimated operative blood loss, post-operative leak, stasis, infection and recurrence.
  
  
  RESULTS
  No tumors were ruptured during surgical manipulation and no major morbidity or mortality occurred in either group. Operative time (75,8 ± 33,1 min in large cases vs 75,8 ± 33,1 min in small cases) was similar in both groups (p = 0,61). The incidence of post-operative complications did not differ between the two groups. In details there were 21 out of 25 (84%) uncomplicated cases among small GISTs versus 17 out of 24 (70,8%) uncomplicated cases among large GISTs (p = 0,32).
  
  
  CONCLUSIONS
  This matched-pair case control study demonstrates that laparoscopic wedge resection for large gastric GISTs is safe and effective, as demonstrated for small tumors.
authors.affiliation: University of Naples "Federico II", Department of Surgical Specialities and Nephrology, Naples, Italy. Electronic address: milone.marco.md@gmail.com.
authors.forename: M
authors.initials: M
authors.lastname: Milone
authors.affiliation: San Raffaele Hospital, Department of Gastrointestinal Surgery, Milan, Italy.
authors.forename: U
authors.initials: U
authors.lastname: Elmore
authors.affiliation: University of Naples "Federico II", Department of Surgical Specialities and Nephrology, Naples, Italy.
authors.forename: M
authors.initials: M
authors.lastname: Musella
authors.affiliation: San Raffaele Hospital, Department of Gastrointestinal Surgery, Milan, Italy.
authors.forename: P
authors.initials: P
authors.lastname: Parise
authors.affiliation: San Raffaele Hospital, Department of Gastrointestinal Surgery, Milan, Italy.
authors.forename: M C
authors.initials: MC
authors.lastname: Zotti
authors.affiliation: University of Naples "Federico II", Department of Surgical Specialities and Nephrology, Naples, Italy.
authors.forename: U
authors.initials: U
authors.lastname: Bracale
authors.affiliation: University of Naples "Federico II", Department of Surgical Specialities and Nephrology, Naples, Italy.
authors.forename: K
authors.initials: K
authors.lastname: Di Lauro
authors.affiliation: University of Naples "Federico II", Department of Surgical Specialities and Nephrology, Naples, Italy.
authors.forename: M
authors.initials: M
authors.lastname: Manigrasso
authors.affiliation: University of Naples "Federico II", Department of Surgical Specialities and Nephrology, Naples, Italy.
authors.forename: F
authors.initials: F
authors.lastname: Milone
authors.affiliation: San Raffaele Hospital, Department of Gastrointestinal Surgery, Milan, Italy.
authors.forename: R
authors.initials: R
authors.lastname: Rosati
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D016063:Blood Loss, Surgical / Q000706:statistics & numerical data; D016022:Case-Control Studies; D016208:Databases, Factual; D005260:Female; D005743:Gastrectomy / Q000379:methods*; D046152:Gastrointestinal Stromal Tumors / Q000473:pathology / Q000601:surgery*; D006801:Humans; D015994:Incidence; D007239:Infections / Q000453:epidemiology; D010535:Laparoscopy; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000453:epidemiology*; D061646:Operative Time; D011183:Postoperative Complications / Q000453:epidemiology*; D012189:Retrospective Studies; D013274:Stomach Neoplasms / Q000473:pathology / Q000601:surgery*; D047368:Tumor Burden
keywords: GIST; Gastrectomy; Gastrointestinal stromal tumor; Laparoscopic; Wedge gastrectomy