Experience with Open and Laparoscopic Surgery for Primary Gastric Stromal Tumors in a Single Institute

Abstract

Laparoscopic surgery has become increasingly popular in the management of gastric gastrointestinal stromal tumors (GISTs) in recent years. One hundred and forty-five patients underwent curative resections of primary gastric stromal tumors between September 2002 and March 2012 were assigned to either an open surgery group (n = 99) or a laparoscopic surgery group (n = 46). In the open surgery group, there was a significantly higher number of samples with a mitotic index ≥ 10 (16.1% vs. 0%), more tumors located in the gastric cardia (13.1% vs. 6.5%), greater operative blood loss (80 mL vs. 50 mL) and a longer postoperative hospital stay (10 days vs. 6 days) than in the laparoscopic group. The surgical morbidity and mortality were 6.1% and 0% in the open group, whereas no complication or mortality in the laparoscopic group. Ten patients in the open group had tumor recurrences and no recurrence in the laparoscopic group. Multivariate analysis showed that tumor size and mitotic index were two independent risk factors associated with tumor recurrence. The 3-year disease-free survival rates and 5-year overall survival rates were similar between the two groups. The laparoscopic approach is a safe alternative procedure for gastric GISTs.