Laparascopy-assisted surgery (LAS) was both feasible and safe for patients with gastrointestinal stromal tumors (GISTs) larger than 5 cm, particularly in the hands of experienced surgeons, according to a study published in Surgery.
The researchers reported improved short-term outcomes and similar oncological results irrespective of the location of the resected tumor.
“Whether laparoscopy-assisted treatment of nongastric GIST >5 cm is safe and feasible remains to be determined,” the authors wrote. In this study, we used data from a large database of a tertiary hospital in China to compare the postoperative and oncologic results of patients with GIST >5 cm after open surgery or LAS, and propensity score matching (PSM) was used to adjust for confounding variables.”
Read more about GIST treatment
The authors included 518 patients with GISTs larger than 5 cm between 23 and 85 years old at a single center between January 2000 and December 2020. The patients were classified into two groups: the LAS group and the open surgery group. Surgical details, demographics, and clinicopathological data were collected, along with modified National Institutes of Health risk classification.
The results of the analysis confirmed that LAS is safe and feasible for GISTs larger than 5 cm, a relatively large diameter, with outcomes similar to those from the open surgery approach. Specifically, LAS presented less blood loss, shorter incisions, shorter time to first flatus, and shorter duration of hospital stay compared to the patients who underwent open surgery.
Importantly, these results were consistent regardless of whether the tumor was in a gastric or nongastric location. The authors caution, however, that the inherent selection bias between the LAS and open groups due to the study’s retrospective nature might have affected the results.
Wang T, Ziong Z, Huang Y, et al. Safety and feasibility of laparoscopy-assisted surgery for gastrointestinal stromal tumors larger than 5 cm: results of a retrospective, single-center series of 1,802 consecutive patients. Surgery. Published online July 19, 2022. doi:10.1016/j.surg.2022.04.049