Comparison of laparoscopic and open resections for gastric gastrointestinal stromal tumors (GISTs)

Abstract

BACKGROUND: Gastrointestinal stromal tumors (GISTs) are the most common mesencyhmal tumors of the gastrointestinal tract. Today surgical resection is still the treatment of choice for primary gastric GISTs. This study compares the laparoscopic versus open surgical resection approaches of gastric GISTs.

METHODS: A retrospective chart review was conducted from our database, and 68 primary gastric GIST resections were found to be performed in our center between 2008- 2020. Of these 68 patients, 57 were included for the study. Open resection was performed in 32 patients, and laparoscopic resection was performed in 25 patients. The medical records were examined and compared for clinical, pathologic and surgical results according to preferred surgical method of choice.

RESULTS: Fifty-seven patients were qualified for the study. The average diameter of the tumor was 4.8 ± 1.91 cm in the laparoscopic group, and 6,8 ± 4,27 cm in open group. Estimated blood loss during the surgery was significantly lower in laparoscopic group patients (100.7 ml vs 287.5 ml) (p< 0.001) and also length of stay was shorter compared with open at 4.4 versus 11.9 days (p < 0.001). Laparoscopic group patients needed less pain medication, and they had quicker return to daily life.

CONCLUSIONS: Laparoscopic approach is safe and feasible with acceptable oncologic outcomes and certain benefits like decreased length of stay, less complication rates and better comfort. The preference of laparoscopic resection should be decided not only on tumor location or diameter but also surgeon’s laparoscopic surgical experience.