BACKGROUND The feasibility of endoscopic dissection for gastric gastrointestinal stromal tumor (gGIST) between 2 and 5 cm in size has been demonstrated. However, its impact on short-term and long-term outcomes, compared with laparoscopic resection, is unknown. The purpose of this study was to compare short-term and long-term outcomes between laparoscopic resection and endoscopic dissection for 2-5-cm gGIST. METHODS A case-matched study was performed using the propensity score. To overcome selection bias, we performed a 1:1 match using six covariates, including age, sex, BMI, ASA score, tumor size, and tumor location. Short-term and long-term outcomes between laparoscopic resection and endoscopic dissection were compared. RESULTS A total of 210 patients with 2-5-cm gGIST were enrolled between 2006 and 2017 in our gastrointestinal center. According to the intention-to-treat approach, 165 patients underwent laparoscopic resection, and 45 patients underwent endoscopic dissection. After the propensity score, 45 pairs were balanced and analyzed. There was no significant difference in the baseline characteristics between the laparoscopic and endoscopic groups after matching. The rate of complications was significantly higher in the endoscopic group compared with the laparoscopic group (P < 0.001). Perforations occurred in 16 patients in the endoscopic group (16/45, 35.6%). The postoperative hospital stay was significantly longer in the endoscopic group compared with the laparoscopic group (P < 0.001). There was no significant difference between the two groups in disease-free survival or overall survival. CONCLUSION Laparoscopic resection is better than endoscopic dissection for 2-5-cm gGIST because of the lower complication rate and shorter hospital stay.

中文翻译：

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对于2至5厘米大小的胃胃肠道间质瘤，腹腔镜切除术优于内镜切除术：在胃肠道中心进行的病例匹配研究。

背景技术已经证明了内窥镜解剖术治疗大小在2至5厘米之间的胃胃肠道间质瘤（gGIST）的可行性。但是，与腹腔镜切除术相比，其对短期和长期结局的影响尚不清楚。这项研究的目的是比较2-5厘米gGIST的腹腔镜切除术和内镜剥离术之间的短期和长期结果。方法使用倾向评分进行病例匹配研究。为了克服选择偏见，我们使用六个协变量进行了1：1匹配，包括年龄，性别，BMI，ASA评分，肿瘤大小和肿瘤位置。比较了腹腔镜切除术和内镜切除术之间的短期和长期结果。结果2006年至2017年之间，我们的胃肠道中心共纳入210例2-5-cm gGIST患者。根据意向性治疗方法，对165例患者进行了腹腔镜切除，对45例患者进行了内镜切除。在倾向得分之后，对45对进行平衡和分析。匹配后，腹腔镜和内镜组的基线特征无明显差异。与腹腔镜组相比，内镜组的并发症发生率明显更高（P <0.001）。内镜组16例发生穿孔（16/45，35.6％）。与腹腔镜组相比，内窥镜组术后住院时间明显更长（P <0.001）。两组的无病生存期或总生存期无显着差异。