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.