AB43. Is it feasible and safe for laparoscopic resection for gastric GIST larger than 5 cm? Result from a prospective cohort study

Background: Role of laparoscopic resection for large (especially larger than 5 cm) gastric GIST is still in debate for the fear of intraoperative tumor rupture.

Methods: To determine the feasibility and safety of laparoscopic approach in treatment of large gastric GIST, a prospective study was carried out between March 2011 and March 2015. Intraoperative tumor rupture was studied as primary outcome. Secondly outcomes were conversion rate, operating time, estimated blood loss, time of tolerate fluid and solid diet, length of postoperative hospital stay and recurrence rate at the end of the follow-up.

Results: Twenty-two patients were included in this study with tumor size 7.04±1.53 cm (range, 5.2-10.8 cm). No intraoperative tumor rupture occurred. The median duration of operation was 88.1±31.9 min with estimated blood loss 37.1±18.7 mL. No patient needed blood transfusion. The average time until start of oral intake for fluid and solid diet was 1.1±0.6 and 2.5±0.9 days, respectively. The median time for length of postoperative hospital stay was 5.4±5.8 days. The follow-up period for all the patients was 18.9±10.2 months (range, 2-47 months). No local or distant recurrence was observed.

Conclusions: Laparoscopic resection for large gastric GIST is feasible and safe. Laparoscopic surgery should be considered as standard approach in all cases irrespective of tumor size and location.