Chun Yuet Khoo1,2, Brian K P Goh3,4, Alvin K H Eng5, Weng-Hoong Chan5, Melissa C C Teo6, Alexander Y F Chung1, Hock-Soo Ong5, Wai-Keong Wong5. 1. Department of Hepatopancreatobiliary and Transplantation Surgery, Singapore General Hospital, 20 College Road, Academia Level 5, Singapore, 169856, Singapore. 2. Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore. 3. Department of Hepatopancreatobiliary and Transplantation Surgery, Singapore General Hospital, 20 College Road, Academia Level 5, Singapore, 169856, Singapore. bsgkp@hotmail.com. 4. Duke-National University of Singapore Medical School, Singapore, Singapore. bsgkp@hotmail.com. 5. Department of Upper Gastrointestinal and Bariatric Surgery, Singapore General Hospital, Singapore, Singapore. 6. Division of Surgical Oncology, National Cancer Center Singapore, Singapore, Singapore.
Abstract
BACKGROUND: Laparoscopic wedge resection (LWR) for small gastric gastrointestinal stromal tumors (GIST) is now widely accepted, but its application for large GISTs remains controversial. This study aims to evaluate the feasibility and safety of LWR for suspected large (≥5 cm) gastric GISTs. METHODS: Retrospective review of 82 consecutive patients who underwent attempted LWR for suspected gastric GIST. LWR for large (≥5 cm) (n = 23) tumors was compared with LWR for small (<5 cm) tumors (n = 59). The 23 patients with LWR for large tumors were also compared to 36 consecutive patients who underwent open wedge resection (OWR) for large tumors. RESULTS: Comparison between patients who underwent LWR for large versus small tumors demonstrated that resection of large tumors was associated with a longer operating time. There was no difference in other perioperative outcomes, and oncological outcomes such as frequency of close margins (≤1 mm) and recurrence-free survival. Comparison between patients who underwent LWR versus OWR for large tumors showed that LWR was associated with decreased median time to fluid or solid diet, shorter postoperative stay but longer operating times. There was no difference in oncological outcomes. CONCLUSION: LWR for suspected large gastric GIST is feasible and safe. It is associated with similar short-term outcomes with LWR for small tumors and favorable short-term outcomes over OWR for large tumors without compromising on oncological outcomes.
BACKGROUND: Laparoscopic wedge resection (LWR) for small gastric gastrointestinal stromal tumors (GIST) is now widely accepted, but its application for large GISTs remains controversial. This study aims to evaluate the feasibility and safety of LWR for suspected large (≥5 cm) gastric GISTs. METHODS: Retrospective review of 82 consecutive patients who underwent attempted LWR for suspected gastric GIST. LWR for large (≥5 cm) (n = 23) tumors was compared with LWR for small (<5 cm) tumors (n = 59). The 23 patients with LWR for large tumors were also compared to 36 consecutive patients who underwent open wedge resection (OWR) for large tumors. RESULTS: Comparison between patients who underwent LWR for large versus small tumors demonstrated that resection of large tumors was associated with a longer operating time. There was no difference in other perioperative outcomes, and oncological outcomes such as frequency of close margins (≤1 mm) and recurrence-free survival. Comparison between patients who underwent LWR versus OWR for large tumors showed that LWR was associated with decreased median time to fluid or solid diet, shorter postoperative stay but longer operating times. There was no difference in oncological outcomes. CONCLUSION: LWR for suspected large gastric GIST is feasible and safe. It is associated with similar short-term outcomes with LWR for small tumors and favorable short-term outcomes over OWR for large tumors without compromising on oncological outcomes.
Authors: Brian K P Goh; Pierce K H Chow; Aik-Yong Chok; Weng-Hoong Chan; Yaw-Fui A Chung; Hock-Soo Ong; Wai-Keong Wong Journal: World J Surg Date: 2010-08 Impact factor: 3.352
Authors: B K P Goh; Y-C Goh; A K H Eng; W-H Chan; P K H Chow; Y-F A Chung; H-S Ong; W-K Wong Journal: Eur J Surg Oncol Date: 2015-04-15 Impact factor: 4.424
Authors: Brian K P Goh; Pierce K H Chow; Wai-Ming Yap; Sittampalam M Kesavan; In-Chin Song; Pradeep G Paul; Boon-Swee Ooi; Yaw-Fui A Chung; Wai-Keong Wong Journal: Ann Surg Oncol Date: 2008-06-11 Impact factor: 5.344
Authors: Brian K P Goh; Pierce K H Chow; Sittampalam M Kesavan; Wai-Ming Yap; Yaw-Fui A Chung; Wai-Keong Wong Journal: J Gastrointest Surg Date: 2010-04 Impact factor: 3.452
Authors: Juan Manuel Sanchez-Hidalgo; Manuel Duran-Martinez; Rafael Molero-Payan; Sebastian Rufian-Peña; Alvaro Arjona-Sanchez; Angela Casado-Adam; Antonio Cosano-Alvarez; Javier Briceño-Delgado Journal: World J Gastroenterol Date: 2018-05-14 Impact factor: 5.742