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Updated: Oct 11, 2025
Laparoscopy-endoscopy Cooperative Surgery for the Treatment of Gastric Gastrointestinal Stromal Tumors
Published on: February 19, 2022
Comparison of effectiveness and safety between endoscopic and surgical resection for 2-5 cm gastric stromal tumors
Yan Li1,2, Liansong Ye1, Xianglei Yuan1
1Department of Gastroenterology, Sichuan University, West China Hospital, No. 37 Guoxue Alley, Wuhou District, Chengdu, 610041, Sichuan Province, China.
Background:
As endoscopic resection remains controversial, this study aims to compare the effectiveness and safety between endoscopic and surgical resection for 2-5 cm gastric stromal tumors (GSTs).
Methods:
Patients with 2-5 cm GST resected at West China Hospital from March 2008 to April 2019 were enrolled. Propensity score matching (PSM) (1:1) was performed to achieve baseline data consistency.
Results:
112 patients were matched between the endoscopic resection group (ER) and the open surgery group. There were no significant differences in the complete resection rate (94.6% vs. 100%), the incidence of complications (25.0% vs. 14.3%), the recurrence rate (0% vs. 1.8%) and the 5-year relapse-free survival (100% vs. 97.9%) (P > 0.05). The ER had a shorter fasting time (3.5 days vs. 5 days), a shorter postoperative hospital stay (7 days vs. 8 days) and a lower hospitalization cost (3,589.16 USD vs. 5,931.24 USD) (P < 0.05). 54 cases were matched between the ER and the laparoscopic surgery group (LS). There were no significant differences in the complete resection rate (92.6% vs. 96.3%), the incidence of complications (22.2% vs. 11.1%), the fasting time (4 days vs. 3 days), the recurrence rate (0% vs. 3.7%) and the 5-year relapse-free survival (100% vs. 96.3%) (P > 0.05). The hospitalization cost (3,589.25 USD vs. 4,715.16 USD) was lower in the ER, and the postoperative hospital stay was shorter in the LS (6 days vs. 7 days) (P < 0.05).
Conclusions:
Although slightly higher incidences of incomplete resection and perforation were shown in the endoscopic resection group, there was insignificant difference between groups (P > 0.05). Endoscopic resection might be an alternative surgical method for 2-5 cm GSTs.
Insights
Endoscopic resection is a safe and effective alternative to surgery for gastric stromal tumors (GSTs) between 2-5 cm, offering shorter recovery times and lower costs without compromising outcomes.
Area of Science:
- Gastroenterology
- Surgical Oncology
- Minimally Invasive Procedures
Background:
- Gastric stromal tumors (GSTs) are mesenchymal neoplasms.
- Surgical resection is standard, but endoscopic resection (ER) is emerging.
- Controversy exists regarding the comparative effectiveness of ER versus surgical resection for 2-5 cm GSTs.
Purpose of the Study:
- To compare the efficacy and safety of endoscopic resection (ER) against surgical resection (SR) for 2-5 cm gastric stromal tumors (GSTs).
Main Methods:
- Retrospective study of patients with 2-5 cm GSTs undergoing ER or SR.
- Propensity score matching (PSM) was used to ensure baseline comparability between groups.
- Outcomes analyzed included complete resection rates, complications, recurrence, and survival.
Main Results:
- No significant differences in complete resection, recurrence, or 5-year relapse-free survival between ER and open surgery (OS) or laparoscopic surgery (LS).
- Endoscopic resection group showed shorter fasting times, shorter hospital stays, and lower hospitalization costs compared to open surgery.
- While ER had slightly higher rates of incomplete resection and perforation, these were not statistically significant.
Conclusions:
- Endoscopic resection demonstrates comparable oncological outcomes to surgical resection for 2-5 cm GSTs.
- ER offers advantages in terms of reduced hospital stay and cost.
- Endoscopic resection may be a viable alternative surgical approach for selected 2-5 cm gastric stromal tumors.
