Yan Zhao1,2, Taohong Pang3,4, Bin Zhang3, Lei Wang3, Ying Lv3, Tingsheng Ling3, Xiaoqi Zhang3, Qin Huang5,6, Guifang Xu7, Xiaoping Zou8,9. 1. Department of Gastroenterology, Nanjing Drum Tower Hospital Clinical College of Nanjing Medical University, NO.321 Zhongshan Road, Nanjing, 210008, Jiangsu, China. 2. Department of Geriatric, The Affiliated Drum Tower Hospital of Nanjing University Medical School, NO.321 Zhongshan Road, Nanjing, 210008, Jiangsu, China. 3. Department of Gastroenterology, The Affiliated Drum Tower Hospital of Nanjing University Medical School, NO.321 Zhongshan Road, Nanjing, 210008, Jiangsu, China. 4. Department of Gastroenterology, Affiliated Chaohu Hospital of Anhui Medical University, No.64 Chaohu North Road, Chaohu, 238000, Anhui, China. 5. Department of Gastroenterology, The Affiliated Drum Tower Hospital of Nanjing University Medical School, NO.321 Zhongshan Road, Nanjing, 210008, Jiangsu, China. qinhuang0122@gmail.com. 6. VA Boston Healthcare System and Harvard, Medical School, West Roxbury, MA, 02132, USA. qinhuang0122@gmail.com. 7. Department of Gastroenterology, The Affiliated Drum Tower Hospital of Nanjing University Medical School, NO.321 Zhongshan Road, Nanjing, 210008, Jiangsu, China. 13852293376@163.com. 8. Department of Gastroenterology, Nanjing Drum Tower Hospital Clinical College of Nanjing Medical University, NO.321 Zhongshan Road, Nanjing, 210008, Jiangsu, China. 13770771661@163.com. 9. Department of Gastroenterology, The Affiliated Drum Tower Hospital of Nanjing University Medical School, NO.321 Zhongshan Road, Nanjing, 210008, Jiangsu, China. 13770771661@163.com.
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.
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.