Laparoscopic versus open resection for unfavorable sites gastric gastrointestinal stromal tumors: a propensity weighted cohort study.

IF 1.6 3区医学 Q2 SURGERY

BMC Surgery Pub Date : 2025-07-03 DOI:10.1186/s12893-025-02994-7

Yang Zong, Yawei Qian, Jianghao Xu, Qingya Li, Linjun Wang, Li Yang, Hao Xu, Jianfeng Gu, Zekuan Xu

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Abstract

Background and objectives: To compare the efficacy and feasibility of laparoscopic resection with those of open surgery for gastric gastrointestinal stromal tumors (GISTs) in unfavorable locations using the propensity score weighting (PSW) method.

Methods: Clinicopathological and follow-up data from 170 patients found to have gastric GISTs in unfavorable locations from January 2017 to December 2021 were analyzed retrospectively. Among the 170 patients, 121 underwent laparoscopic surgery, and 49 underwent open surgery. The PSW was used to create balanced cohorts and adjusted for six clinically validated covariates: sex, age, BMI, tumor size, mitotic rate, and recurrence risk.

Results: After PSW, 325.2 patients, consisting of 167 laparoscopic (Lap group) and 158.2 open surgery (Open group) patients, were matched. The Lap group had shorter operation times (84.7 ± 37.7 min versus 123.4 ± 46.9 min, P < 0.001) and shorter hospital stays (7.0 [5.0, 8.0] days versus 9.0 [8.0, 11.0] days, P < 0.001) than the Open group. Although the Open group exhibited a numerically higher complication rate (10.24% vs. 4.97%), this difference did not reach statistical significance (P = 0.243). Moreover, no significant differences existed in recurrence-free survival or overall survival.

Conclusions: Laparoscopic surgery is safe and feasible for gastric GISTs in unfavorable locations. Compared with open surgery, laparoscopic resection facilitates faster postoperative recovery and has a similar long-term prognosis.

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腹腔镜与开放切除不利部位胃肠道间质瘤：倾向加权队列研究。

背景与目的：应用倾向评分加权（PSW）法比较不利部位胃胃肠道间质瘤（gist）腹腔镜切除与开放手术的疗效和可行性。方法：回顾性分析2017年1月至2021年12月170例胃gist不良部位患者的临床病理及随访资料。170例患者中，121例行腹腔镜手术，49例行开放手术。PSW用于创建平衡队列，并根据六个临床验证的协变量进行调整：性别、年龄、BMI、肿瘤大小、有丝分裂率和复发风险。结果：PSW后，共匹配325.2例患者，其中腹腔镜（Lap组）167例，开放手术（open组）158.2例。Lap组手术时间（84.7±37.7 min）短于Lap组（123.4±46.9 min）， P结论：腹腔镜手术治疗胃gist不良部位是安全可行的。与开放手术相比，腹腔镜切除术后恢复更快，远期预后相似。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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