Xiaoyu Dong, Ziming Cui, Meiting Fu, Jixiang Zheng, Ying Lin, Jiaying Liao, Huijuan Le, Jun Yan. Department of General Surgery, Nanfang Hospital, Southern Medical University
Background: The feasibility of the endoscopic dissection for gastric gastrointestinal stromal tumor (gGIST) between 2 and 5 centimeter (cm) has been demonstrated. However, its impact on short-term and long-term outcomes remains unknown. The purpose of this study was to compare short-term and long-term outcomes between laparoscopic resection and endoscopic dissection for 2-5cm gGIST.
Methods: A case-matched study was performed using propensity score. To overcome selection biases, we performed a 1:1 match using five covariates, including gender, age, American society of anesthesiology score (ASA), tumor location and tumor size. Short-term and long-term outcomes between laparoscopic resection and endoscopic dissection were compared.
Results: 210 patients with 2-5cm gGIST were enrolled between 2006 and 2017 in our gastrointestinal center. According to intention-to-treat, 165patients underwent laparoscopic resection and 45 patients underwent endoscopic dissection. After propensity score, 45 pairs was balanced and analyzed. There was no significant difference in the baseline characteristics between laparoscopic group and endoscopic group. The rate of complications was significantly higher in the endoscopic group, compared with laparoscopic group (P<0.001). Perforations occurred in 16 cases in endoscopic group (16/45, 35.6%). The postoperative hospital stay was significantly longer in the endoscopic group, compared with laparoscopic group (P<0.001). There was no significant difference between two groups in disease-free survival and overall survival.
Conclusion: Laparoscopic resection is better than endoscopic dissection for 2-5cm gGIST because of lower complication rate and shorter hospital stay.
Presented at the SAGES 2017 Annual Meeting in Houston, TX.
Abstract ID: 95077
Program Number: S023
Presentation Session: Foregut I
Presentation Type: Podium