Updates in surgery · 2026
Laparoscopic resection for gastric gastrointestinal stromal tumor at the esophagogastric junction: feasibility and long-term results.
СтатьяСравнительное исследованиеНазвание и аннотация: Перевод пока не подготовлен
Обработка статьи · этапы, ошибки и управление
Загрузка состояния…
Ошибки и ограничения
История · было → стало
Состояние обновляется каждые 5 секунд, пока блок открыт. Процент показывается только там, где известен объём работы. Пауза останавливает продолжение этапа; текущий запрос к источнику может завершиться.
Liao Yi, Huang Jintuan, Chen Hao, Chen Chunyu, Xiang Jun, Yang Zuli
Аннотация
BACKGROUND AND AIM: Despite laparoscopic resection's established role in gastric gastrointestinal stromal tumor (GIST) management, its application for esophagogastric junction (EGJ) tumors involving the Z-line remains technically challenging and insufficiently studied. This study compares feasibility, safety, and oncologic outcomes of laparoscopic versus open resection for EGJ-GIST.
METHODS: A retrospective cohort analysis included 45 patients undergoing EGJ-GIST resection (24 laparoscopic, 21 open). Perioperative metrics and survival outcomes were evaluated, with clinicopathological parameters systematically compared.
RESULTS: Groups had similar baseline characteristics. Laparoscopic surgery showed superior intraoperative outcomes, including reduced median blood loss (47.5 vs 85.0 mL, p < 0.001). Postoperatively, laparoscopic patients experienced faster gastrointestinal recovery (first flatus: 2 vs 3 days, p = 0.004), earlier dietary advancement (liquid: 3 vs 4 days, p = 0.003; solid: 4 vs 5 days, p < 0.001), and shorter hospitalization (6 vs 8 days, p = 0.002). Complication rates trended lower with laparoscopy (8.3% vs 23.8%, p = 0.306). Over 68-month median follow-up, recurrence occurred in 5 patients (laparoscopic:3; open:2). Five-year disease-free survival (DFS) (86.3% vs 87.7%) and overall survival (OS) (92.9% vs 93.3%) were comparable, with no intergroup differences in Kaplan-Meier analysis (DFS: p = 0.644; OS: p = 0.506). Multivariate analysis confirmed surgical approach did not independently affect prognosis.
CONCLUSIONS: Laparoscopic resection for EGJ-GIST offers significant perioperative benefits-reduced blood loss, faster recovery, and fewer complications-while demonstrating comparable descriptive long-term survival rates to open surgery. These findings advocate prioritizing minimally invasive techniques in surgically selected cases.
METHODS: A retrospective cohort analysis included 45 patients undergoing EGJ-GIST resection (24 laparoscopic, 21 open). Perioperative metrics and survival outcomes were evaluated, with clinicopathological parameters systematically compared.
RESULTS: Groups had similar baseline characteristics. Laparoscopic surgery showed superior intraoperative outcomes, including reduced median blood loss (47.5 vs 85.0 mL, p < 0.001). Postoperatively, laparoscopic patients experienced faster gastrointestinal recovery (first flatus: 2 vs 3 days, p = 0.004), earlier dietary advancement (liquid: 3 vs 4 days, p = 0.003; solid: 4 vs 5 days, p < 0.001), and shorter hospitalization (6 vs 8 days, p = 0.002). Complication rates trended lower with laparoscopy (8.3% vs 23.8%, p = 0.306). Over 68-month median follow-up, recurrence occurred in 5 patients (laparoscopic:3; open:2). Five-year disease-free survival (DFS) (86.3% vs 87.7%) and overall survival (OS) (92.9% vs 93.3%) were comparable, with no intergroup differences in Kaplan-Meier analysis (DFS: p = 0.644; OS: p = 0.506). Multivariate analysis confirmed surgical approach did not independently affect prognosis.
CONCLUSIONS: Laparoscopic resection for EGJ-GIST offers significant perioperative benefits-reduced blood loss, faster recovery, and fewer complications-while demonstrating comparable descriptive long-term survival rates to open surgery. These findings advocate prioritizing minimally invasive techniques in surgically selected cases.