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Updated: Apr 18, 2026
Laparoscopy-endoscopy Cooperative Surgery for the Treatment of Gastric Gastrointestinal Stromal Tumors
Published on: February 19, 2022
Endoscopic versus open resection for small gastric gastrointestinal stromal tumors: safety and outcomes
Chaoyong Shen1, Haining Chen, Yuan Yin
1From the Department of Gastrointestinal Surgery (CS, HC, YY, JC, BZ, ZC, JC); and Intensive Care Unit (LH), West China Hospital, Sichuan University, Chengdu, Sichuan, China.
Abstract:
Endoscopic resection has been performed to treat small gastric neoplasms. However, this technique for small gastric gastrointestinal stromal tumors (GISTs) remains controversial. This study aims to compare the safety and surgical outcomes of endoscopic versus open resection of small gastric GISTs.The medical records of 54 consecutive gastric GISTs patients with tumor size of ≤2 cm, who were surgically treated with endoscopic resection (endoscopic group) or open surgery (laparotomy group) in a single institution from March 2010 to June 2014, were retrospectively analyzed. The clinical and tumor characteristics, surgical safety, and tumor-related outcomes were evaluated.Of 54 patients, 32 and 22 patients underwent endoscopic resection and laparotomy, respectively. Patients who underwent endoscopic resection yielded a significantly shorter hospital stay compared with patients who underwent laparotomy (P < 0.001). Compared with patients in the endoscopic group, patients in the laparotomy group had more intraoperative blood loss (P < 0.001), had longer nasogastric tube retention (P < 0.001), and required longer operative time (P < 0.001). More laparotomy patients required postoperative analgesic drugs than those in the endoscopic group (n = 9 vs 4; P = 0.016). Gastric perforation occurred in 1 case during operation in the endoscopic group. Patients who underwent these 2 procedures did not differ with respect to tumor size (P = 0.168), perioperative transfusion (P = 1.000), reoperation (P = 1.000), early satiety (P = 0.560), and postoperative bleeding (P = 1.000). With a median follow-up time of 34.5 months, 1 high-risk patient in each group experienced tumor recurrence/metastasis postoperatively.The endoscopic procedure allows safe resection with good surgical outcomes for small gastric GISTs compared with laparotomy. Moreover, larger randomized controlled trials are warranted to confirm endoscopic application for small gastric GISTs.
Insights
Endoscopic resection is a safe and effective treatment for small gastric gastrointestinal stromal tumors (GISTs), offering shorter hospital stays and fewer complications than open surgery. Further research is needed to confirm these findings in larger trials.
Area of Science:
- Gastroenterology
- Surgical Oncology
- Minimally Invasive Surgery
Background:
- Endoscopic resection is used for small gastric neoplasms, but its application for small gastric gastrointestinal stromal tumors (GISTs) is debated.
- Open surgery (laparotomy) is a traditional approach for GISTs.
Purpose of the Study:
- To compare the safety and surgical outcomes of endoscopic resection versus open surgery for small gastric GISTs (≤2 cm).
Main Methods:
- Retrospective analysis of 54 patients with gastric GISTs (≤2 cm) treated between March 2010 and June 2014.
- Patients were divided into endoscopic resection (n=32) and open surgery (laparotomy, n=22) groups.
- Evaluation of clinical characteristics, surgical safety, and tumor-related outcomes.
Main Results:
- Endoscopic resection resulted in significantly shorter hospital stays, less intraoperative blood loss, shorter nasogastric tube retention, and shorter operative times compared to laparotomy.
- Fewer patients in the endoscopic group required postoperative analgesics.
- One case of gastric perforation occurred during endoscopic resection.
- No significant differences were observed in tumor size, perioperative transfusion, reoperation, early satiety, or postoperative bleeding between groups.
- Tumor recurrence/metastasis occurred in one high-risk patient in each group during a median follow-up of 34.5 months.
Conclusions:
- Endoscopic resection is a safe procedure with favorable surgical outcomes for small gastric GISTs when compared to laparotomy.
- Larger randomized controlled trials are recommended to validate the use of endoscopic resection for small gastric GISTs.
