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Long‐term outcomes of endoscopic submucosal dissection versus laparoscopic resection for gastric stromal tumors less than 2 cm
Author(s) -
Meng Yan,
Li Wei,
Han Lu,
Zhang Qiang,
Gong Wei,
Cai Jianqun,
Li Aimin,
Yan Qun,
Lai Qiuhua,
Yu Jiang,
Bai Lan,
Liu Side,
Li Yue
Publication year - 2017
Publication title -
journal of gastroenterology and hepatology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.214
H-Index - 130
eISSN - 1440-1746
pISSN - 0815-9319
DOI - 10.1111/jgh.13768
Subject(s) - medicine , endoscopic submucosal dissection , surgery , retrospective cohort study , gastroenterology , survival rate , medical record , significant difference , endoscopy
Abstract Background and Aim Laparoscopic resection (LAP) and endoscopic submucosal dissection (ESD) of small gastrointestinal stromal tumors (GISTs) have been reported by large amount of literature. However, the management of small GISTs remains controversial. This study evaluated the efficacy of ESD and LAP for small gastric GISTs and provided long‐term outcomes of the two methods. Methods A total of 126 patients who underwent ESD or LAP for small gastric GISTs between 2009 and 2016 were retrospectively collected from medical records in our hospital, and we made telephone follow‐up about recurrence rate. The parameters measured for each procedure type include clinicopathological characteristics, recurrence rate, and surgical outcomes. Results Among the 126 patients, 75 (59.52%) received ESD, and 51(40.48%) received LAP. The clinicopathological characteristics of the patients were well balanced. There was also no significant difference in follow‐up time (3.34 ± 1.53 years in ESD group and 3.41 ± 1.37 years in LAP group, P = 0.19). However, we observed significant difference about operating time, estimated blood loss, and hospital stay between ESD group and LAP group (63.59 ± 34.41 min vs 79.12 ± 43.47 min, P = 0.04; 8.53 ± 15.89 mL vs 17.16 ± 18.90 mL, P = 0.01; 6.60 ± 2.70 days vs 10.37 ± 3.50 days, P < 0.001, respectively). The recurrence rate of ESD and LAP group was 2.67% and 1.96%, respectively, P = 0.41. Kaplan–Meier curves for disease‐free survival also showed no statistically significant difference ( P = 0.72). Conclusions Endoscopic submucosal dissection is a preferable technique for resection of small gastric stromal tumors in the long‐term outcomes compared with LAP. However, long‐term randomized controlled trials are further needed.