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The Mayo Clinic Experience

Kevin L. Huguet, MD; Robert M. Rush Jr, MD; Deron J. Tessier, MD; Richard T. Schlinkert, MD; Ronald A. Hinder, MD, PhD; Gary G. Grinberg, MD; Michael L. Kendrick, MD; Kristi L. Harold, MD

Arch Surg. 2008;143(6):587-590.

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.

Author Affiliations: Department of Surgery, Mayo Clinic Scottsdale, Scottsdale, Arizona (Drs Huguet, Rush, Tessier, Schlinkert, and Harold); Department of Surgery, Mayo Clinic Jacksonville, Jacksonville, Florida (Dr Hinder); and Department of Surgery, Mayo Clinic Rochester, Rochester, Minnesota (Drs Grinberg and Kendrick).

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