Laparoscopic Surgery for Large Gastric Submucosal Tumors.

Background:In general, laparoscopic resection for gastric gastrointestinal stromal tumors (GISTs) >5cm is not recommended. However, there is a lack of evidence to support this recommendation.Patients and Methods:This study included 108 patients who underwent laparoscopic surgery for gastric GISTs. Of the 108 patients, 23 had GISTs>5cm. The aim of this study is to evaluate the oncological safety of laparoscopic surgery for large gastric GISTs. In addition, we performed a rapid systematic review of laparoscopic surgery for large gastric GISTs.Results:In our cases, all patients were performed R0 resection without capsular rupture and surgical margins were negative on pathologic examination. In all studies, en bloc resection was achieved without capsular rupture in all patients. The average positive surgical margins rate was 1.6% in total reports.Conclusions:The laparoscopic approach for large gastric GISTs>5cm has been proposed as safe when performed by experienced surgeons.