Gastric gastrointestinal stromal tumors: clinical features and short- and long-term outcomes of laparoscopic resection

Introduction
Although minimally invasive techniques are currently recognized as effective and validated treatment for small gastric gastrointestinal stromal tumors (GISTs), the role of laparoscopy is not yet established, especially in the institutions that have less experience in minimally invasive surgery.

Aim
To evaluate the outcomes of laparoscopic treatment of gastric gastrointestinal stromal tumors compared to the results obtained in a group of patients treated with conventional surgery.

Material and methods
A retrospective analysis of data collected for a group of 68 patients treated for gastric GIST in the period from 2002 to 2017 was performed. Forty-six patients were treated laparoscopically (group 1) and 22 patients underwent conventional surgery (group 2). The analyzed medical data included clinical and pathomorphological features of removed tumors, perioperative parameters as well as short and long-term results of surgical treatment.

Results
Histopathological examination confirmed radical resection for all patients. No deaths were reported in the 30-day post-operative period. Patients in group 1 had significantly shorter length of hospital stay (3 vs. 9 days), less intra-operative blood loss (25 vs. 175 ml) and fewer perioperative complications (13% vs. 41%) compared to group 2. The mean post-operative follow-up was 57 months. During this period, four patients died for reasons unrelated to the primary disease. None of the patients who underwent a laparoscopic procedure had a recurrence of the tumor in the follow-up period.

Conclusions
Laparoscopy in the treatment of gastric GISTs has unquestionable advantages, including decreased blood loss, reduced risk of complications, and shorter hospital stay.