Endoscopic, laparoscopic and open gastric resection for relatively small (2-4 cm) primary gastric gastrointestinal stromal tumors: a size-matched study

Hao Xu, Xiaofei Zhi, Fengyuan Li, Wang Miao, Li Yang, Zekuan Xu. Department of Gastric Surgery, the First Affiliated Hospital of Nanjing Medical University

Background: Endoscopic, laparoscopic and open surgeries are optional approaches for the relatively small gastrointestinal stromal tumors (GISTs). However, it remains to be seen which approach is the best. In this size-matched study, we compared the short-term and long-term outcomes among these approaches.

Methods: The study involved a retrospective review of 80 consecutive patients with tumor size between 2 and 4 cm, who underwent resection of gastric GISTs. Clinical data, perioperative and oncologic outcomes were evaluated.

Results: There were 18 patients in endoscopic group, 20 patients in laparoscopic group and 42 patients in open group. There was no significant difference in the baseline characteristics among the three groups, as expected. Endoscopic resection showed to be the minimal invasive approach with the shortest operation time, the lowest blood loss, the shortest postoperative hospital stay, and the shortest time to liquid diet and semi-liquid diet. Also, laparoscopic surgery showed better results compared with open surgery. The three groups had no significant difference in hospital charges and grade 3+ complications. No recurrence occurred during follow-up.

Conclusions: Endoscopic resection appears to be an effective, safe and feasible minimal invasive approach for relatively small gastric GISTs.

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