ObjectiveTo investigate the feasibility and safety of laparoscopic resection in treatment of gastric stromal tumors at difficult sites.MethodsA retrospective analysis of 64 cases of gastric stromal tumors at the difficult sites in Renmin Hospital of Wuhan University from January 2013 to October 2018 was performed. According to the patient’s surgical procedure, 64 cases were divided into two groups, there were 26 cases in the laparoscopic group and 38 cases in the open group. The clinical pathology data, surgical indexes, and follow-up results of the two groups were compared.ResultsAll the operations were successfully completed, and the patients in the laparoscopic group did not conversate to open surgery. There were no complications such as postoperative hemorrhage, anastomotic leakage, cardia or pyloric stenosis, abdominal infection, and no positive margin and tumor rupture. The postoperative venting time, visual analogue scale of pain on 1 day after operation, and hospital stay in the laparoscopic group were better than those of the open group (P<0.05). There were no local recurrence cases in the two groups. In the open group, two cases of middle-high risk patients did not take imatinib according to the doctor’s advice and suffered from liver metastasis. In the laparoscopic group, one case of high-risk patient did not take medicine regularly and suffered from liver metastasis too. There was no significant difference in survival situation between the two groups (P>0.05).ConclusionLaparoscopic resection is safe and feasible for gastric stromal tumors with a diameter of less than 5 cm, it has shorter recover time and shorter hospital stay than open surgery, which can be clinically promoted.