The long term outcomes of laparoscopic intragastric surgery for gastric gastrointestinal stromal tumors

Ken Hagiwara. Department of Digestive Surgery. Nihon University School of Medicine

BACKGROUD: Laparoscopic intragastric resection (LIGR) became a good surgical option with its gastric functional preservation for intraluminal growth gastric gastrointestinal stromal tumors (GISTs). However, the long-term oncological and functional outcomes were unknown.

OBJECTIVE: The aim of this study were to evaluate the long-term outcomea of LIGR for intraluminal type of GISTs.

METHODS: Between Jan. 2005 and Aug. 2014, a total of 11 consecutive patients undergoing laparoscopic intragastric resection for gastric GISTs in our hospital were enrolled in this study. Survival, recurrence, digestive complaint and endscopic finding were analyzed retrospectively. Follow-up assessment included abdominal CT scans every 6 months for first 2 years and yearly thereafter and endoscopy yearly. Adjuvant chemotherapy was not performed. We used Miettnen’s risk classification.

RESULTS: Patients (11cases; 2males and 9 females) with a median age of 70 years (range 39-84) were evaluated. The tumors were located in upper thied in all cases. The procedures included conventional approach (3ports) in 2cases and single port access approach in 9 cases. LIGR was possible in all case. The median operative time was 90min (range 68-157) and the blood loss was a little. Tumors were resected successfully without tumor rupture, major peri-operative complications nor conversions to the open surgery. Mortality rate was 0%. The median postoperative stay was 7days (range 4-9). The median size of tumor was 30mm (range7-48) and very low risk group was 2 cases and low risk group was 9 cases. No esophagitis was seen in endscopic finding at one year after surgery. No recurrence and no gastrointestinal complaint occurred during a median follow-up period of 32months.

CONCLUSIONS: Our study supports the evidence that laparoscopic intragastric resection for GISTs which is intraluminal type, less than 5cm and located in upper third of stomach is feasible, safe, and effective on long-term clinical outcomes.

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