Minimally invasive treatment of laparoscopic and endoscopic cooperative surgery for patients with gastric gastrointestinal stromal tumors

摘要

Objective: To evaluate the feasibility and safety of laparoscopic and endoscopic cooperative surgery (LECS) for the treatment of gastric gastrointestinal stromal tumors (GISTs). Methods: We retrospectively reviewed the data of 69 consecutive patients who underwent LECS, including laparoscopy-assisted endoscopic resection (LAER) and endoscopy-assisted laparoscopic wedge resection (EAWR), for pathologically confirmed gastric GISTs of less than 5cm in diameter from January 2006 to October 2012. Results: The tumor was located at the upper third of the stomach in 22 patients, the middle third in 38 and the lower third in nine, with a mean tumor size of 2.8±1.6cm. The operating time was 81.6±31.8min in the LAER group and 86.3±28.5min in the EAWR group (P=0.776). Intraoperative blood loss was 29.8±15.4mL in the LAER group and 31.4±11.6mL in the EAWR group (P=0.561). Most patients had a very low or low risk of tumor recurrence, while six had an intermediate risk of tumor recurrence. The mean length of postoperative hospital stay was 4.6 days. Only two patients had postoperative complications after LECS, both of whom were treated successfully without open surgery. During a median follow-up of 35 months, all patients were disease-free, with no tumor recurrence or metastases. Conclusion: LECS is a minimally invasive and safe alternative approach which can achieve fast recovery and satisfactory short-term outcomes for appropriately selected patients with gastric GISTs.