Laparoscopic management of GIST Tumors-Outcomes
Rama Rao Ganga M, Jessica Ardila-Gatas MD, Chaohui Zheng MD, Emanuele Lo Menzo MD
and Raul Rosenthal MD
Dept of Surgery, Cleveland Clinic Florida, Weston, FL, 33331
Introduction: Gastrointestinal Stromal Tumors (GISTs) are mostly benign neoplasms. GIST’s that are ≥ 2
cm in size should be resected because they can become malignant and invade neighboring organs.
Laparoscopic resection has become the procedure of choice with superior outcomes to open techniques
with shorter recovery and less morbidity and equivalent results from an oncologic point of view. The aim
of this study is to review our experience with laparoscopic resection of GISTs with regards to
complications.
Methods: We reviewed our database for GIST tumors from 2002-2014. Patient demographics, tumor
characteristics, duration of procedure, complications and length of stay were reviewed. Student`s T,
Fisher`s exact tests are utilized to provide comparison between laparoscopic and open procedures.
Results: Of the 39 total patients with GISTs, 29 (74%) patients underwent laparoscopic resections.
Three patients required conversion to an open procedure; two of them due to tumor size (6.5-13 cms)
and the other for resection of hepatic metastasis. Seven (18%) patients underwent laparotomy due to
the size and extent of the tumor on preoperative assessment.
Age (m)
BMI
Procedure length(m)
Tumor Size (m)
Complications
Short Term
Long term
Laparoscopic (29)
61.55
34
107 (40-180)
3.4 cms (0.6-9.5)
Open(10)
60.60
27
160 (120-240)
9.2 cms (2.1-18.5)
p-value
0.62
0.09
0.001
0.00004
2 (Duodenal leak,
Atrial fibrillation)
2( Pancreatico
cuatneous fistula,
Acute kidney injury)
2 (Upper GI Bleed,
Hepatic metastasis)
0.26
8.5 d(3-26)
0.10
5 (2- Anastomotic
stenosis, 1-SBO, 1Abdominal abscess, 1Pleural effusion)
Length of stay(m)
5.1 d(1-18)
m-mean, d-days, SBO-small bowel obstruction
0.99
Conclusions: Laparoscopic technique appears to be safe for small GIST tumors resection with no
difference in complication rate. Shorter length of stay is observed with laparoscopic resections.