***TASK*** the task is to summarize an input biomedical literature in six sentences 
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    Input: Background Laparoscopic resection of gastric GISTs  appears technically feasible and associated with favorable outcomes . Tumor size however frequently plays a role in surgical approach with larger tumors tending toward laparotomy , raising concern that favorable outcomes reported for the laparoscopic approach may reflect this selection bias . Material s and Methods From a prospect ively collected sarcoma data base , 155 primary gastric GIST resections were identified ( 1998–2009 ) ; 40 patients underwent successful laparoscopic resection for non-GE junction GIST and were r and omly matched ( 1:1 ) by tumor size ( ±2.0 cm ) to patients 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 blood loss ( 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 tumor location at the GE junction or lesser curve . Conclusions When matched for tumor size , laparoscopic resection of primary gastric GISTs ≤8 cm results in shorter hospital stays with similar OR time while maintaining sound oncologic outcomes compared with open resection Abstract Published reports on laparoscopic resection of gastric gastrointestinal stromal tumor ( GIST ) were limited to small experiences and selection bias . Two hundred fourteen patients who underwent primary gastric GIST resection at our institution ( January 2006–December 2012 ) were identified from a prospect ively collected data base .  Laparoscopic resections ( LAP ) were performed in 133 patients , and open resections ( OPEN ) were performed in 81 patients . The short- and long-term outcomes were analyzed using propensity-score matching ( PSM ) by comparing the clinicopathological factors between these groups . The tumor resection method and tumor size were significantly different between the LAP and OPEN groups . After PSM , there were no differences ( P > 0.05 ) in these clinicopathological factors . The LAP group had less blood loss and shorter operation time , time to first flatus , time to first fluid diet , time to gastric tube removal , and postoperative stay before PSM . In addition , there were no differences regarding the time of drainage tube removal or hospitalization expense . Other than the time of gastric tube removal , which was similar in these 2 groups , the short-term outcomes were similar before and after PSM . The rates of postoperative complications in the LAP and OPEN groups were 6.8 % and 22.8 % , respectively , before PSM ( P = 0.001 ) and 5.6 % and 22.5 % , respectively , after PSM ( P = 0.004 ) . The multivariate analyses for complications showed that tumors were located in the middle of the stomach , and the operation method and proximal gastrectomy were independent risk factors before and after PSM . The 5-year cumulative survival rates in the LAP and OPEN groups were 95.4 % and 85.9 % , respectively , ( P = 0.07 ) before PSM and 93.1 % and 91.9 % , respectively , ( P = 0.69 ) after PSM ( not significantly different).Laparoscopic resection for gastric GISTs had better short-term outcomes and similar long-term outcomes compared with open surgery . Localized gastric GISTs can be treated with laparoscopic surgery Background Subepithelial gastric tumors are common findings during upper gastrointestinal endoscopy . Tumor resection is mostly done laparoscopically , but there is still discussion concerning the size of lesion for which the treatment may be minimally invasive ; additionally there is very little data available concerning patient outcome after minor access surgery . Methods Clinicopathologic features and survival data of 93 consecutive patients undergoing a combined laparoscopic-endoscopic approach for gastric submucosal tumors  were prospect ively analyzed . Analysis included preoperative diagnostic work-up , perioperative data , and postoperative complications . Follow-up was carried out for patients with GIST to check for tumor recurrence . Results It was possible to resect 88 of 93 lesions by the laparoscopic-endoscopic approach , with tumor-free margins in all patients . Intraoperative endoscopy facilitated exact tumor localization in 92 patients . Most lesions were removed by endoscopic-laparoscopic wedge resection or , less frequently , by a combined transgastric approach .  Mean operative time was 90.7 min ; the postoperative hospitalization was 7.3 days . Adverse events appeared in 7.5 % , and conversion to open surgery was required in 6.5 % . For patients suffering from gastrointestinal stromal tumors , there was no tumor recurrence at a mean follow-up of 40 months . Conclusions Combined laparoscopic-endoscopic “ rendez-vous ” procedures are easy to perform and offer a curative approach for almost all gastric submucosal lesions . The technique is associated with low morbidity and short hospitalization . Though even patients with large GISTs of intermediate and high risk were treated , no tumor recurrence has been observed to date Introduction Gastrointestinal stromal tumors ( GIST ) are uncommon gastric neoplasms , which are typically treated by surgical excision . During the past 10 years , our institution has gained experience in resecting these tumors by minimally invasive methods . The purpose of this study is to review our experience with laparoscopic resection , report our short-term outcomes , and offer our perspective on the technical nuances involved in h and ling these neoplasms . Methods We retrospectively queried our prospect ively maintained , institutional review board-approved data base for all gastric GISTs resected from 2002 to 2012 . We analyzed all cases that were resected via laparoscopy .  Operative notes were review ed for the technique employed . Data on tumor location , size , margin status , operative time , and blood loss were collected and analyzed . Results During the 10-year study period , 104 gastric GISTs were resected .  Laparoscopy was attempted in 58 cases with only one conversion to an open procedure . Tumors were separated based on anatomic zones . Forty-seven tumors ( 82 % ) were located on the body or fundus of the stomach ( 18 on the posterior wall and 29 on the anterior wall ) . Five GISTs ( 9 % ) were located at the gastroesophageal junction ( GEJ ) . Five tumors ( 9 % ) were located at the antrum . The mean tumor size was 3.8 cm with a mean estimated blood loss of 40 ml . We achieved R0 resection in 100 % of the cases . Most tumors ( 96 % ) were amenable to wedge resection . Tumors at the extremes of the stomach required variations of technique to achieve resection . Intraoperative endoscopy was selectively utilized . Conclusions As our experience with gastric GISTs has increased , laparoscopic resection has become our first-line treatment for most small- and moderate-sized tumors . By employing a structured approach to tumors along the entire stomach , laparoscopic resection of these tumors can be performed safely with adequate short-term results BACKGROUND Laparoscopic resection of gastric gastrointestinal stromal tumors ( GISTs ) has been shown by several retrospective studies to be technically feasible and associated with favorable outcomes when compared to the open approach . This study aims to mitigate potential selection bias by performing a case control study of laparoscopic ( LWR ) versus open wedge resection ( OWR ) matched by resection type , location and tumor size . METHODS We retrospectively identified 50 consecutive patients who underwent LWR for a suspected gastric GIST from a prospect i ve data base and matched this cohort with 50 patients who underwent OWR .  RESULTS There was no statistical difference between the key baseline clinicopathological features of patients ' who underwent LWR  versus  OWR . Patients who underwent LWR had longer operating times [ 150 ( range , 65 - 270 ) minutes vs 92.5 ( 25 - 200 ) minutes , P < .001 ] but decreased median blood loss [ 0 ( 0 - 300 ) ml vs 0 ( 0 - 1200 ) ml , P = .015 ] , decreased frequency of intraoperative or postoperative blood transfusion [ 1 ( 2 % ) vs 8 ( 16 % ) , P = .031 ] , decreased median time to liquid diet [ 2 ( 0 - 5 ) vs 3 ( 1 - 7 ) days , P < .001 ] , decreased median time to solid diet [ 3 ( 1 - 6 ) vs 5 ( 2 - 11 ) days , P < .001 ] and decreased postoperative stay [ 4 ( 2 - 10 ) vs 4.5 ( 3 - 17 ) , P < .001 ] compared to OWR . There was no difference in oncological outcomes such as frequency of close margins ( ≤ 1 mm ) and recurrence-free survival . CONCLUSION This matched case-control study provides supporting evidence that LWR results in superior perioperative outcomes compared to OWR without compromising on oncological outcomes BACKGROUND Postoperative pneumonia ( PP ) is a major complication that has been linked to microaspiration of pathogens originating in the gastrointestinal tract . This prospect i ve study was performed to define the role of gastric bacterial aspiration in the development of PP . METHODS Informed consent was obtained before operations from 140 veterans scheduled for major elective procedures requiring nasogastric tubes  , and cultures were obtained of the gastric contents and sputum twice daily after operation . RESULTS PP developed in 26 ( 18.6 % ) of 140 patients . The patients who had PP did not differ from those with no pneumonia after operation except for a history of chronic obstructive pulmonary disease , which was found in 38.5 % of those with PP compared with 20 % of patients with no pneumonia ( p < 0.05 ) . Morbidity was increased in association with PP , because length of stay in the surgical intensive care unit ( 6.2 vs 2.6 days ) , days intubated ( 2.7 vs 0.6 ) , total postoperative days ( 15.3 vs 8.4 ) , and mortality rates ( 19.2 % vs 1.7 % ) were greater than in patients with no pneumonia . Gastric pathogens were present on entry in 38 % of patients , and 32 % of these had PP compared with 13 % whose initial gastric cultures were sterile ( p = 0.01 ) . Colonization of sputum for greater than 24 hours with gastric pathogens occurred in 28 % of patients . These patients had a 40 % incidence of PP compared with 12 % in patients without such evidence of microaspiration ( p < 0.01 ) . CONCLUSIONS PP is a morbid postoperative complication associated with not only chronic obstructive pulmonary disease but also the presence of gastric bacteria during operation and transmission of gastric bacteria to the pulmonary tree after operation BACKGROUND Improving surgical quality of care requires accurate reporting of postoperative complications . STUDY DESIGN Accuracy of a prospect i ve surgical complication grading data base was assessed by performing a retrospective review of 204 pancreaticoduodenectomies ( PDs ) entered into the data base from January 1 , 2001 , to December 31 , 2003 . This up date d data base was then used to characterize 30-day morbidity and mortality after PD . RESULTS On review , 13 % of patients had a complication not identified in the prospect i ve complication data base , 8 % of patients had a complication reclassified , and 4 % of patients had a complication removed . At least 1 postoperative complication was experienced by 47 % of patients . After PD , 45 different complications occurred . Postoperative mortality at 30 days was 1 % , and 30-day readmission rate was 11 % . The 30-day reoperation rate was 9 % , and 14 % of patients required a percutaneous drainage procedure . Pancreatic anastomotic leak ( 12 % ) , wound infection ( 11 % ) , and delayed gastric emptying ( 7 % ) were the 3 most common postoperative complications , and all were associated with an increased length of stay . CONCLUSIONS Our prospect i ve surgical complication data base accurately characterized outcomes after PD and facilitated information gathering and analysis . The accuracy , efficiency , and reproducibility of a prospect i ve surgical complication data base favor its widespread use in postoperative complication reporting Background Laparoscopic resection of gastric gastrointestinal stromal tumors ( GISTs ) appears technically feasible and associated with favorable outcomes . Tumor size plays an important role in surgical approach , with laparotomy tending to be used to treat larger tumors . This study evaluated the technical feasibility , safety , and oncologic efficacy of laparoscopic surgery for 
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CONCLUSIONS Laparoscopic surgery is safe and feasible for the treatment of GISTs including less operative time and intraoperative blood loss , earlier postoperative recovery , shorter hospital stay , and lower rate of overall complications and recurrence