Laparoscopic gastric gastrointestinal stromal tumor resection: the mayo clinic experience.
HYPOTHESIS
Laparoscopic resection of gastric gastrointestinal stromal tumors (GISTs) is safe and effective.


DESIGN
Retrospective medical record review.


SETTING
Tertiary referral center.


PATIENTS
Patients undergoing laparoscopic resection of gastric GISTs from April 1, 2000, to April 1, 2006.


MAIN OUTCOME MEASURES
Demographic data, diagnostic workup, operative technique, tumor characteristics, morbidity, mortality, and follow-up.


RESULTS
Thirty-three patients underwent attempted laparoscopic resection of gastric GISTs, with 31 operations completed laparoscopically. The mean patient age was 68 years (age range, 35-86 years). The female to male ratio was 18:15. Sixteen patients (49%) were asymptomatic, and their tumors were found incidentally. Of 24 patients (73%) who underwent preoperative endoscopic ultrasonography, the results of fine-needle aspiration verified the diagnosis in 13 patients (54%). The mean operative time was 124 minutes (range, 30-253 minutes). A combined endoscopic-laparoscopic approach was used in 11 patients (33%). The mean tumor size was 3.9 cm (range, 0.5-10.5 cm). Two patients (6%) underwent conversion to an open procedure. The median hospital stay duration was 3 days. The mean follow-up was 13 months (range, 3-64 months). There were no local recurrences. Three patients (9%) experienced complications, including 1 wound infection and 2 episodes of upper gastrointestinal tract bleeding. There were no mortalities.


CONCLUSION
Although technically demanding, the laparoscopic approach to gastric GISTs is safe and effective, resulting in a short hospital stay duration and low morbidity.