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Laparoscopic resection is better than endoscopic dissection for gastric gastrointestinal stromal tumor between 2 and 5 cm in size: a case-matched study in a gastrointestinal center

  • 2019 SAGES Oral
  • Published:
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Abstract

Background

The feasibility of endoscopic dissection for gastric gastrointestinal stromal tumor (gGIST) between 2 and 5 cm in size has been demonstrated. However, its impact on short-term and long-term outcomes, compared with laparoscopic resection, is unknown. The purpose of this study was to compare short-term and long-term outcomes between laparoscopic resection and endoscopic dissection for 2–5-cm gGIST.

Methods

A case-matched study was performed using the propensity score. To overcome selection bias, we performed a 1:1 match using six covariates, including age, sex, BMI, ASA score, tumor size, and tumor location. Short-term and long-term outcomes between laparoscopic resection and endoscopic dissection were compared.

Results

A total of 210 patients with 2–5-cm gGIST were enrolled between 2006 and 2017 in our gastrointestinal center. According to the intention-to-treat approach, 165 patients underwent laparoscopic resection, and 45 patients underwent endoscopic dissection. After the propensity score, 45 pairs were balanced and analyzed. There was no significant difference in the baseline characteristics between the laparoscopic and endoscopic groups after matching. The rate of complications was significantly higher in the endoscopic group compared with the laparoscopic group (P < 0.001). Perforations occurred in 16 patients in the endoscopic group (16/45, 35.6%). The postoperative hospital stay was significantly longer in the endoscopic group compared with the laparoscopic group (P < 0.001). There was no significant difference between the two groups in disease-free survival or overall survival.

Conclusion

Laparoscopic resection is better than endoscopic dissection for 2–5-cm gGIST because of the lower complication rate and shorter hospital stay.

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Acknowledgements

This work was supported by the National Natural Science Foundation of China (Grant nos. 81773117, 81771881, 81700576, and 81672446), the National Key Basic Research Program of China (Grant no. 2015CB352006), the National Clinical Key Specialty Construction Program (Grant no. [2011]170), the State’s Key Project of Research and Development Plan (Grant nos. 2017YFC0108300 and 2017YFC0108302), the Special Fund for Guangdong Province Public Research and Capacity Building (Grant no. 2014B020215002), the Natural Science Foundation of Guangdong Province (Grant no. 2015A030308006), the Guangzhou Industry University Research Cooperative Innovation Major Project (Grant no. 201704020062), the Special Fund from Clinical Research of Wu Jieping Medical Foundation (Grant no. 320.2710.1851), Clinical Research Startup Program of Southern Medical University by High-Level University Construction Funding of Guangdong Provincial Department of Education (Grant no. LC2016PY010), the High-Level Research Matching Foundation of Nanfang Hospital (Grant no. 2014067), the Scientific Research Foundation for High-Level Talents in Nanfang Hospital of Southern Medical University (Grant no. 201404280056), the Special Funds for the Cultivation of Guangdong College Students’ Scientific and Technological Innovation (Grant no. pdjh2019b0098), the Training Program for Undergraduate Innovation and Entrepreneurship (Grant nos. 201812121265, and 201812121039S), and the Scientific Enlightenment Plan of Southern Medical University (Grant no. B1000494).

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Author notes

  1. Xiaoyu Dong, Weisheng Chen and Ziming Cui have contributed equally to this article.

Authors and Affiliations

  1. Department of General Surgery, Nanfang Hospital, Southern Medical University, No. 1838, North Guangzhou Avenue, Guangzhou, 510515, Guangdong, People’s Republic of China

    Xiaoyu Dong, Weisheng Chen, Ziming Cui, Tao Chen, Xiumin Liu, Dexin Chen, Wei Jiang, Kai Li, Shumin Dong, Mingyuan Feng, Jixiang Zheng, Zhiming Li, Ying Lin, Jiaying Liao, Huijuan Le & Jun Yan

  2. Department of Gastroenterology, Nanfang Hospital, Southern Medical University, Guangzhou, 510515, Guangdong, People’s Republic of China

    Meiting Fu

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  1. Xiaoyu Dong
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Corresponding author

Correspondence to Jun Yan.

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Disclosures

Drs. Xiaoyu Dong, Weisheng Chen, Ziming Cui, Tao Chen, Xiumin Liu, Dexin Chen, Wei Jiang, Kai Li, Shumin Dong, Mingyuan Feng, Jixiang Zheng, Zhiming Li, Meiting Fu, Ying Lin, Jiaying Liao, Huijuan Le, and Jun Yan have no conflicts of interest or financial ties to disclose.

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Dong, X., Chen, W., Cui, Z. et al. Laparoscopic resection is better than endoscopic dissection for gastric gastrointestinal stromal tumor between 2 and 5 cm in size: a case-matched study in a gastrointestinal center. Surg Endosc 34, 5098–5106 (2020). https://doi.org/10.1007/s00464-019-07251-6

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  • DOI: https://doi.org/10.1007/s00464-019-07251-6

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