Analysis of safety and efficacy of laparoscopic resection for gastrointestinal stromal tumors of the stomach and little bowel: Review of literature

Gastrointestinal stromal tumors (GISTs) are rare tumors representing 0.1%–3% of all gastrointestinal cancers with an estimated incidence of 15/million. These tumors are characterized by the overexpression of the tyrosine kinase receptor KIT (CD117). The diagnosis of GIST has dramatically increased since 1992, and survival has greatly improved since 2002 when the Food and Drug Administration approved imatinib mesylate. Surgical treatment is the only chance of cure for patients with primary localized GIST. There is no surgical consensus about laparoscopic or open surgical treatment. However, the role for laparoscopy in the resection of GISTs continues to expand. The laparoscopic approach for gastric GISTs offers significant advantages in terms of postoperative pain, surgical trauma, and hospitalization, with the same oncological results obtained with open surgery while today it is considered the gold standard of treatment only for small gastric GIST. Controversy surrounds the maximum diameter of GIST for laparoscopic resection. We present our experience of 33 cases of GIST at Sant'Anna Hospital (Ferrara) in a period between 1999 and 2017 with a literature review.