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Comparison of short- and long-term outcomes of laparoscopic vs open resection for gastric gastrointestinal stromal tumors.
- Source :
-
World journal of gastroenterology [World J Gastroenterol] 2017 Jul 07; Vol. 23 (25), pp. 4595-4603. - Publication Year :
- 2017
-
Abstract
- Aim: To compare the short- and long-term outcomes of laparoscopic (LR) vs open resection (OR) for gastric gastrointestinal stromal tumors (gGISTs).<br />Methods: In total, 301 consecutive patients undergoing LR or OR for pathologically confirmed gGISTs from 2005 to 2014 were enrolled in this retrospective study. After exclusion of 77 patients, 224 eligible patients were enrolled (122 undergoing LR and 102 undergoing OR). The demographic, clinicopathologic, and survival data of all patients were collected. The intraoperative, postoperative, and long-term oncologic outcomes were compared between the LR and OR groups following the propensity score matching to balance the measured covariates between the two groups.<br />Results: After 1:1 propensity score matching for the set of covariates including age, sex, body mass index, American Society of Anesthesiology score, tumor location, tumor size, surgical procedures, mitotic count, and risk stratification, 80 patients in each group were included in the final analysis. The baseline parameters of the two groups were comparable after matching. The LR group was significantly superior to the OR group with respect to the operative time, intraoperative blood loss, postoperative first flatus, time to oral intake, and postoperative hospital stay ( P < 0.05). No differences in perioperative blood transfusion or the incidence of postoperative complications were observed between the two groups ( P > 0.05). No significant difference was found in postoperative adjuvant therapy ( P = 0.587). The mean follow-up time was 35.30 ± 26.02 (range, 4-102) mo in the LR group and 40.99 ± 25.07 (range, 4-122) mo in the OR group with no significant difference ( P = 0.161). Survival analysis showed no significant difference in the disease-free survival time or overall survival time between the two groups ( P > 0.05).<br />Conclusion: Laparoscopic surgery for gGISTs is superior to open surgery with respect to intraoperative parameters and postoperative outcomes without compromising long-term oncological outcomes.<br />Competing Interests: Conflict-of-interest statement: The authors have no conflicts of interest to declare.
- Subjects :
- Adult
Aged
Aged, 80 and over
Blood Loss, Surgical statistics & numerical data
Blood Transfusion statistics & numerical data
Disease-Free Survival
Female
Gastrectomy adverse effects
Gastrectomy mortality
Gastrointestinal Stromal Tumors mortality
Gastrointestinal Stromal Tumors pathology
Gastroscopy adverse effects
Gastroscopy methods
Gastroscopy mortality
Humans
Incidence
Intraoperative Period
Kaplan-Meier Estimate
Laparoscopy adverse effects
Laparoscopy mortality
Length of Stay statistics & numerical data
Male
Middle Aged
Neoplasm Recurrence, Local pathology
Operative Time
Postoperative Complications etiology
Postoperative Period
Propensity Score
Retrospective Studies
Stomach Neoplasms mortality
Stomach Neoplasms pathology
Time Factors
Treatment Outcome
Young Adult
Gastrectomy methods
Gastrointestinal Stromal Tumors surgery
Laparoscopy methods
Neoplasm Recurrence, Local epidemiology
Postoperative Complications epidemiology
Stomach Neoplasms surgery
Subjects
Details
- Language :
- English
- ISSN :
- 2219-2840
- Volume :
- 23
- Issue :
- 25
- Database :
- MEDLINE
- Journal :
- World journal of gastroenterology
- Publication Type :
- Academic Journal
- Accession number :
- 28740348
- Full Text :
- https://doi.org/10.3748/wjg.v23.i25.4595