Twelve years of gastric GIST A retrospective study of laparoscopic and open approach.

PURPOSE: The authors wanted to evaluate the outcome of laparoscopic and open resection for gastric GISTs, in the long and short run with a retrospective study based on 63 consecutive patients.

METHODS: Two surgical groups were compared according to age, sex, ASA group and Surgical procedure: a laparoscopic resection was performed on 30 patients (47,7%) while the open approach was preferred for 33 patients (52,3%). Duration of surgery, blood loss, positive resection margins, postoperative morbidity, postoperative ileus, hospital stay, tumor's mean dimensions, degree of malignancy and recurrences rate and 5-years mortality were compared in subgroups.

RESULTS: Significant differences between Open Gastrectomy group and Laparoscopic Gastrectomy group were found in blood loss 425 ml (180-610) vs 137 ml (110-320), postoperative ileus 4,1D (3-6) vs 2,3D (1-7), hospital stay 15D (8-25) vs 10D (8-17), neoplasia mean dimensions in patients who underwent total gastrectomy ( 7,1±0,9 cm vs 5,3±0,5 cm) and atypical gastrectomy (4,3±0,8 cm vs 2,2±0,3 cm), high degree of malignancy in patients who underwent subtotal gastrectomy (4 vs 0 pz) and 5-years mortality in patients who underwent total gastrectomy (36.6% vs 12.5%).

CONCLUSIONS: Poor blood loss, shorter postoperative ileus and shorter hospital stay in the LG group show that laparoscopy can be performed safely and efficiently in gastric GISTs.