Comparison of the post-operative outcomes and survival of laparoscopic versus open resections for gastric gastrointestinal stromal tumors: A multi-center prospective cohort study

• Laparoscopic resection is the preferred surgical approach in treating gastric GISTs.
• Long term complications and survival in GIST is equivalent between open and laparoscopic resection.
• Endoscopic-assisted laparoscopic surgery improves surgical precision.

Background and objectivesLaparoscopic resection (LR) is increasingly performed for gastrointestinal stromal tumor (GIST). The aim of this study is to investigate the short-term outcomes and therapeutic effects of LR compared to open resection (OR) of gastric GISTs.MethodsDuring 2009–2014, a prospective cohort of 200 patients with gastric GISTs indicated for resection underwent LR and OR procedures in three centers in Shanghai. Patient demographics, peri-operative complications, and clinical outcomes were compared between the two groups.ResultsAfter exclusions, 176 patients who underwent gastric GIST resections were compared, of which 91 were laparoscopic, 85 were open. Compared to open surgery, laparoscopic resection of GIST has shorter operative time (102 vs. 172 min, p < 0.001), lower blood loss (100 vs 144 ml, p < 0.001), and shorter length of stay (9.1 vs. 15.3 d, p < 0.001). No statistical significant difference is observed for time to bowel function or semi-liquid diet, complications, recurrence rates, and mortality.ConclusionLR is a safe and efficacious treatment for gastric GISTs, providing the advantages of shorter operative time, reduced blood loss, and shorter length of stay, all without compromising post-operative outcomes and survival.