Feasibility and safety of laparoscopic resection for gastric GISTs larger than 5 cm: Results from a prospective study

Cao,Feng; Li,Ang; Li,Jia; Fang,Yu; Li,Fei

doi:10.3892/ol.2015.3547

October-2015 Volume 10 Issue 4

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October-2015 Volume 10 Issue 4

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Article Open Access

Feasibility and safety of laparoscopic resection for gastric GISTs larger than 5 cm: Results from a prospective study

Authors:
- Feng Cao
- Ang Li
- Jia Li
- Yu Fang
- Fei Li
View Affiliations / Copyright

Affiliations: Department of General Surgery, Xuanwu Hospital, Capital Medical University, Beijing 100053, P.R. China

Copyright: © Cao et al. This is an open access article distributed under the terms of Creative Commons Attribution License.
Pages: 2081-2086
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Published online on: July 30, 2015

https://doi.org/10.3892/ol.2015.3547
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Abstract

The role of laparoscopic resection for large gastric gastrointestinal stromal tumors (GISTs), particularly those >5 cm, remains under debate due the possibility of intraoperative tumor rupture. To determine the feasibility and safety of the laparoscopic approach in the treatment of large gastric GISTs, a prospective study was performed between March 2011 and March 2014. Intraoperative tumor rupture was studied as the primary outcome. Secondary outcomes were the conversion rate, surgical duration, estimated blood loss, time to tolerate fluid and solid diets, length of post‑operative hospital stay and recurrence rate at the end of the follow‑up. A total of 16 patients were included in this study, with a tumor size of 7.04±1.53 cm (range, 5.2‑10.8 cm). No intraoperative tumor rupture occurred. The median duration of surgery was 88.1±31.9 min, with an estimated blood loss volume of 37.1±18.7 ml. No patient required a blood transfusion. The mean time until the start of oral intake for fluid and solid diets was 1.1±0.6 and 2.5±0.9 days, respectively. The median length of post‑operative hospital stay was 5.4±5.8 days. The follow‑up period for all patients was 16.9±11.2 months (range, 2‑38 months). No local or distant recurrence was observed. The study indicates that laparoscopic resection for large gastric GISTs is feasible and safe. Laparoscopic surgery should be considered as the standard approach in all cases, irrespective of tumor size or location.

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1	DeVogelaere K, Hoorens A, Haentjens P and Delvaux G: Laparoscopic versus open resection of gastrointestinal stromal tumors of the stomach. Surg Endosc. 27:1546–1554. 2013. View Article : Google Scholar : PubMed/NCBI
2	Honda M, Hiki N, Nunobe S, Ohashi M, Kiyokawa T, Sano T and Yamaguchi T: Long-term and surgical outcomes of laparoscopic surgery for gastric gastrointestinal stromal tumors. Surg Endosc. 28:2317–2322. 2014. View Article : Google Scholar : PubMed/NCBI
3	Tabrizian P, Sweeney RE, Uhr JH, Nguyen SQ and Divino CM: Laparoscopic resection of gastric and small bowel gastrointestinal stromal tumors: 10-Year experience at a single center. J Am Coll Surg. 218:367–373. 2014. View Article : Google Scholar : PubMed/NCBI
4	Valle M, Federici O, Carboni F, Carpano S, Benedetti M and Garofalo A: Gastrointestinal stromal tumors of the stomach: The role of laparoscopic resection. Single-centre experience of 38 cases. Surg Endosc. 28:1040–1047. 2014. View Article : Google Scholar : PubMed/NCBI
5	DeVogelaere K, Van Loo I, Peters O, Hoorens A, Haentjens P and Delvaux G: Laparoscopic resection of gastric gastrointestinal stromal tumors (GIST) is safe and effective, irrespective of tumor size. Surg Endosc. 26:2339–2345. 2012. View Article : Google Scholar : PubMed/NCBI
6	Shu ZB, Sun LB, Li JP, Li YC and Ding DY: Laparoscopic versus open resection of gastric gastrointestinal stromal tumors. Chin J Cancer Res. 25:175–182. 2013.PubMed/NCBI
7	Kakeji Y, Nakanoko T, Yoshida R, Eto K, Kumashiro R, Ikeda K, Egashira A, Saeki H, Oki E, Morita M, et al: Laparoscopic resection for gastrointestinal stromal tumors in the stomach. Surg Today. 42:554–558. 2012. View Article : Google Scholar : PubMed/NCBI
8	Zheng L, Ding W, Zhou D, Lu L and Yao L: Laparoscopic versus open resection for gastric gastrointestinal stromal tumors: A meta-analysis. Am Surg. 80:48–56. 2014.PubMed/NCBI
9	Liang JW, Zheng ZC, Zhang JJ, Zhang T, Zhao Y, Yang W and Liu YQ: Laparoscopic versus open gastric resections for gastric gastrointestinal stromal tumors: A meta-analysis. Surg Laparosc Endosc Percutan Tech. 23:378–387. 2013. View Article : Google Scholar : PubMed/NCBI
10	Koh YX, Chok AY, Zheng HL, Tan CS, Chow PK, Wong WK and Goh BK: A systematic review and meta-analysis comparing laparoscopic versus open gastric resections for gastrointestinal stromal tumors of the stomach. Ann Surg Oncol. 20:3549–3560. 2013. View Article : Google Scholar : PubMed/NCBI
11	The ESMO/European Sarcoma Network Working Group, . Gastrointestinal stromal tumors: ESMO clinical practice guidelines for diagnosis, treatment and follow-up. Ann Oncol. 23 (Suppl 7):vii49–vii55. 2012.PubMed/NCBI
12	vonMehren M, Randall RL, Benjamin RS, Boles S, Bui MM, Casper ES, Conrad EU III, Delaney TF, Ganjoo KN, George S, Gonzalez RJ, et al: National Comprehensive Cancer Network: Soft tissue sarcoma, version 2.2014. J Natl Compr Canc Netw. 12:473–483. 2014.PubMed/NCBI
13	Chinese expert committee of gastrointestinal stromal tumor, . Chinese expert consensus of GIST. Zhonghua Wei Chang Wai Ke Za Zh. 15:301–307. 2012.
14	Takahashi T, Nakajima K, Miyazaki Y, Kurokawa Y, Yamasaki M, Miyata H, Takiguchi S, Nishida T, Mori M and Doki Y: Surgical strategy for the gastric gastrointestinal stromal tumors (GISTs) larger than 5 cm: Laparoscopic surgery is feasible, safe and oncologically acceptable. Surg Laparosc Endosc Percutan Tech. 25:114–118. 2015. View Article : Google Scholar : PubMed/NCBI
15	Lin J, Huang C, Zheng C, Li P, Xie J, Wang J and Lu J: Laparoscopic versus open gastric resection for larger than 5 cm primary gastric gastrointestinal stromal tumors (GIST): A size-matched comparison. Surg Endosc. 28:2577–2583. 2014. View Article : Google Scholar : PubMed/NCBI
16	Owens WD, Felts JA and Spitznagel EL Jr: ASA physical status classifications: A study of consistency of ratings. Anesthesiology. 49:239–243. 1978. View Article : Google Scholar : PubMed/NCBI
17	Pucci MJ, Berger AC, Lim PW, Chojnacki KA, Rosato EL and Palazzo F: Laparoscopic approaches to gastric gastrointestinal stromal tumors: An institutional review of 57 cases. Surg Endosc. 26:3509–3514. 2012. View Article : Google Scholar : PubMed/NCBI
18	Privette A, McCahill L, Borrazzo E, Single RM and Zubarik R: Laparoscopic approaches to resection of suspected gastric gastrointestinal stromal tumors based on tumor location. Surg Endosc. 22:487–494. 2008. View Article : Google Scholar : PubMed/NCBI
19	Joensuu H: Risk stratification of patients diagnosed with gastrointestinal stromal tumor. Hum Pathol. 39:1411–1419. 2008. View Article : Google Scholar : PubMed/NCBI
20	Sasaki A, Nitta H, Otsuka K, Fujiwara H, Takahara T and Wakabayashi G: Single-port versus multiport laparoscopic resection for gastric gastrointestinal stromal tumors: A case-matched comparison. Surg Today. 44:1282–1286. 2014. View Article : Google Scholar : PubMed/NCBI
21	Melstrom LG, Phillips JD, Bentrem DJ and Wayne JD: Laparoscopic versus open resection of gastric gastrointestinal stromal tumors. Am J Clin Oncol. 35:451–454. 2012. View Article : Google Scholar : PubMed/NCBI
22	Chen YH, Liu KH, Yeh CN, Hsu JT, Liu YY, Tsai CY, Chiu CT, Jan YY and Yeh TS: Laparoscopic resection of gastrointestinal stromal tumors: Safe, efficient and comparable oncologic outcomes. J Laparoendosc Adv Surg Tech A. 22:758–763. 2012. View Article : Google Scholar : PubMed/NCBI
23	Ma JJ, Hu WG, Zang L, Yan XW, Lu AG, Wang ML, Li JW, Feng B, Zhong J and Zheng MH: Laparoscopic gastric resection approaches for gastrointestinal stromal tumors of stomach. Surg Laparosc Endosc Percutan Tech. 21:101–105. 2011. View Article : Google Scholar : PubMed/NCBI
24	Karakousis GC, Singer S, Zheng J, Gonen M, Coit D, DeMatteo RP and Strong VE: Laparoscopic versus open gastric resections for primary gastrointestinal stromal tumors (GISTs): A size-matched comparison. Ann Surg Oncol. 18:1599–1605. 2011. View Article : Google Scholar : PubMed/NCBI
25	Sexton JA, Pierce RA, Halpin VJ, Eagon JC, Hawkins WG, Linehan DC, Brunt LM, Frisella MM and Matthews BD: Laparoscopic gastric resection for gastrointestinal stromal tumors. Surg Endosc. 22:2583–2587. 2008. View Article : Google Scholar : PubMed/NCBI
26	Novitsky YW, Kercher KW, Sing RF and Heniford BT: Long-term outcomes of laparoscopic resection of gastric gastrointestinal stromal tumors. Ann Surg. 243:738–745. 2006. View Article : Google Scholar : PubMed/NCBI
27	Amin AT, Kono Y, Shiraishi N, Yasuda K, Inomata M and Kitano S: Long-term outcomes of laparoscopic wedge resection for gastrointestinal stromal tumors of the stomach of less than 5 cm in diameter. Surg Laparosc Endosc Percutan Tech. 21:260–263. 2011. View Article : Google Scholar : PubMed/NCBI
28	Nishida T, Hirota S, Yanagisawa A, Sugino Y, Minami M, Yamamura Y, Otani Y, Shimada Y, Takahashi F and Kubota T: GIST Guideline Subcommittee: Clinical practice guidelines for gastrointestinal stromal tumor (GIST) in Japan: English version. Int J Clin Oncol. 13:416–430. 2008. View Article : Google Scholar : PubMed/NCBI
29	Ronellenfitsch U, Staiger W, Kähler G, Ströbel P, Schwarzbach M and Hohenberger P: Perioperative and oncological outcome of laparoscopic resection of gastrointestinal stromal tumour (GIST) of the stomach. Diagn Ther Endosc. 2009:2861382009. View Article : Google Scholar : PubMed/NCBI
30	Cao F, Li J, Li A, Fang Y and Li F: One-stage laparoscopic resection for a large gastric gastrointestinal stromal tumor and synchronous liver metastases following preoperative imatinib therapy: A case report. Oncol Lett. 5:1233–1236. 2013.PubMed/NCBI