Laparoscopic versus open gastric resections for primary XXXX ( @entity674 ): a size-matched comparison.

@entity1 @entity5 @entity190 @entity674 @entity356
BACKGROUND: Laparoscopic resection of gastric @entity674 appears technically feasible and associated with favorable outcomes. @entity5 size however frequently plays a role in surgical approach with @entity5 tending toward laparotomy, raising concern that favorable outcomes reported for the laparoscopic approach may reflect this selection bias. MATERIALS AND METHODS: From a prospectively collected sarcoma database, 155 primary @entity356 resections were identified (1998-2009); 40 @entity1 underwent successful laparoscopic resection for non-GE junction GIST and were randomly matched (1:1) by @entity5 size (  2.0  cm) to @entity1 with open resection. Clinical and pathologic variables and surgical outcomes were associated with surgery type using conditional logistic regression analyses. RESULTS: The two surgical approaches were comparable for clinical and pathologic variables. Median operating room (OR) time was similar, although median length of stay postsurgery was lower in the laparoscopic versus open group (4 vs. 7  days, P  =  0.002), as was estimated @entity190 (EBL) (25 vs. 100  ml, P  =  0.006). There was no operative mortality, and 30-day morbidity was similar. Oncologic outcomes were also similar with no positive microscopic margins, and 1 recurrence in each group with a median follow-up of 34  months. There were 13 conversions overall, 5 secondary to @entity5 location at the GE junction or lesser curve. CONCLUSIONS: When matched for @entity5 size, laparoscopic resection of primary gastric @entity674  <=8  cm results in shorter hospital stays with similar OR time while maintaining sound oncologic outcomes compared with open resection.
