ABSTRACT
OBJECTIVE: To compare the clinical efficacy of laparoscopic wedge resection and open wedge resection in the treatment of gastrointestinal stromal tumor. METHODS: Fifty-five patients with gastrointestinal stromal tumor who underwent laparoscopic wedge resection and 61 cases underwent open wedge resection in Tongji Hospital from January 2009 to December 2014 were included into this study. The perioperative, surgical operative and postoperative data of the patients were documented and analyzed. RESULTS: The operation time of laparoscopic group was significantly shorter than that of the open group [(108.2±27.2) min versus (139.9±75.3) min,P=0.021], the amount of intraoperative blood loss was overtly reduced in the laparoscopic group [(57.1±48.7) ml versus (100.6±45.8) ml,P=0.011], the time to postoperative exhaust or defecation was (2.2±1.4) d in the laparoscopic group and (3.5±1.8) d in the open group (P=0.028), and the length of hospital stay was (5.7±1.3) d versus (6.9±2.1) d (P=0.044). There were intraoperative complication in one case and postoperative complications in 5 cases, while neither tumor rupture nor obvious perioperative complication was observed in the laparoscopic group. During the period of follow-up (mean, 15.3 months), only one case of replase occurred in the laparoscopic group while four cases of relapse were observed in the open group. CONCLUSIONS: With experienced skills and to strictly comply with the surgical indications, laparoscopic wedge resection is prior to tranditional open wedge resection for the treatment of gastrointestinal stromal tumor. The laparoscopic wedge resection can achieve the standard of R0 resection, keep the resected tumor with an intact capsule, reduce the operating time and operative trauma, promote the postoperative recovery and get a better prognosis. Therefore, it is a feasible, safe, minimally invasive surgical procedure associated with a rapid postoperative recovery.
