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Retrospective Comparison of Endoscopic Full-Thickness Versus Laparoscopic or Surgical Resection of Small (≤ 5 cm) Gastric Gastrointestinal Stromal Tumors

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Journal of Gastrointestinal Surgery Aims and scope

Abstract

Aim and Background

The aim of this study was to compare the efficacy and safety between endoscopic full-thickness resection (EFR) and laparoscopic or surgical resection methods for gastric gastrointestinal stromal tumor (GIST) in size of 5.0 cm or less. Gastric GISTs are common, and resection is the most effective treatment.

Method

We retrospectively reviewed 216 resections of gastric GISTs in size of up to 5.0 cm at our center from 2009 to 2017.Eligible resection cases were divided into EFR (n = 85), laparoscopic(n = 64), and surgical (n = 67) groups. The clinical records, patient demographic, symptoms, perioperative data, pathological findings, and long-term follow-up outcomes were collected and compared statistically.

Results

No tumor rupture or recurrence occurred in the three groups. The prevalence of complications was significantly lower in EFR (5.9%) than both laparoscopic (7.8%) and surgical group (16.4%) (P < 0.01). In EFR group, the R0 resection rate (95.3%) was significantly lower than in the laparoscopic group and surgical group (100%) (P < 0.001). The hospital cost (OR = 62.79, CI: 12.954–304.363, P < 0.0001) were significantly lower in the EFR than in the laparoscopic group. The hospital cost (OR = 39.032, CI: 8.045–189.371, P < 0.0001) and post-operative diet time (OR = 2.779, CI: 1.225–6.304, P < 0.05) were also significantly lower in the EFR than in the surgical group.

Conclusion

EFR was a feasible treatment for gastric GISTs of size of ≤ 5.0 cm with an acceptable complete resection rate. In addition, EFR had significantly fewer postoperative complications, shorter length of hospital stay, and lower cost.

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Acknowledgments

Thanks to all the authors for their contributions to this article.

Funding

This work was supported by grants from the National Natural Science Foundation of China (Grant Nos. 81572338 and 81201909) and the Nanjing Medical Science and Technology Development Program No. YKK16078. This work was also part of a C-class sponsored research project of the Jiangsu Provincial Six Talent Peaks (WSN-078).

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Author notes

  1. Yan Zhao, Taohong Pang and Bin Zhang contributed equally to this work.

Authors and Affiliations

  1. Department of Gastroenterology, Nanjing Drum Tower Hospital Clinical College of Nanjing Medical University, NO.321 Zhongshan Road, Nanjing, 210008, Jiangsu, China

    Yan Zhao & Xiaoping Zou

  2. Department of Geriatric, The Affiliated Drum Tower Hospital of Nanjing University Medical School, NO.321 Zhongshan Road, Nanjing, 210008, Jiangsu, China

    Yan Zhao

  3. Department of Gastroenterology, The Affiliated Drum Tower Hospital of Nanjing University Medical School, NO.321 Zhongshan Road, Nanjing, 210008, Jiangsu, China

    Taohong Pang, Bin Zhang, Lei Wang, Ying Lv, Tingsheng Ling, Xiaoqi Zhang, Qin Huang, Guifang Xu & Xiaoping Zou

  4. Department of Gastroenterology, Affiliated Chaohu Hospital of Anhui Medical University, No.64 Chaohu North Road, Chaohu, 238000, Anhui, China

    Taohong Pang

  5. VA Boston Healthcare System and Harvard, Medical School, West Roxbury, MA, 02132, USA

    Qin Huang

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  1. Yan Zhao
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Contributions

X. Z. approved the final version. G. X. contributed to the conception of the study. Q. H. revised the study critically for important intellectual content. Y. Z. performed the data analyses and wrote the manuscript. T. P. and B. Z. contributed significantly to analysis and manuscript preparation. L. W., Y. L., T. L., and X. Z. contributed significantly to acquired data.

Corresponding authors

Correspondence to Qin Huang, Guifang Xu or Xiaoping Zou.

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Zhao, Y., Pang, T., Zhang, B. et al. Retrospective Comparison of Endoscopic Full-Thickness Versus Laparoscopic or Surgical Resection of Small (≤ 5 cm) Gastric Gastrointestinal Stromal Tumors. J Gastrointest Surg 24, 2714–2721 (2020). https://doi.org/10.1007/s11605-019-04493-6

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