Feasibility and Safety of Laparoscopic Resection of Gastrointestinal Stromal Tumors

Background: Surgery is still the main stay in treatment of gastro-intestinal (GIST) tumors. Laparoscopic resection should be considered in these cases as their biological behavior doesn't require large margins of excision or extensive lymph nodes dissection. Patients and methods: A retrospective analysis of 15 patients who underwent laparoscopic resection of GIST. We reviewed the demographics of the patients, diagnostic tools, operative details, and post-operative course. Results: The mean age of the patients was 49 years. Fifty three % were males and 47% were females. The main symptoms were abdominal pain, anemia, and nausea and/or vomiting. GIST was in the stomach in 9 patients and in the small intestine in 6 patients. The mean size of gastric GIST was 4.4 cm and the mean size of small intestinal GIST was 4 cm. Laparoscopy was successfully done in 14 patients. Only 1 conversion was needed in gastric GIST to control bleeding from short gastric vessels. No tumor rupture occurred. The mean operative time was 118.4 minutes and margins of excision were negative in all the cases. Fifty three % were very low risk, 27% were low risk, 7% were intermediate risk, and 13% were high risk. Post-operatively, mean time to pass flatus was 1.6 days. Mean time to tolerate full oral intake was 3.8 days. Mean number of narcotic doses was 2.73. Mean length of hospital stay was 4.9 days. One patient had post-operative atelectasis, and 1 patient had superficial umbilical wound infection. During a mean follow up period of 12.6 months, no recurrence or metastasis could be detected. Conclusion: Laparoscopic resection of GIST is a safe and feasible technique that gives the patient all the advantages of minimally invasive surgery without compromising the oncological outcomes