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Background and aim <p>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.</p> Methods <p>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.</p> Results <p>Groups had similar baseline characteristics. Laparoscopic surgery showed superior intraoperative outcomes, including reduced median blood loss (47.5 vs 85.0&#xa0;mL, <i>p</i> &lt; 0.001). Postoperatively, laparoscopic patients experienced faster gastrointestinal recovery (first flatus: 2 vs 3&#xa0;days, <i>p</i> = 0.004), earlier dietary advancement (liquid: 3 vs 4&#xa0;days, <i>p</i> = 0.003; solid: 4 vs 5&#xa0;days, <i>p</i> &lt; 0.001), and shorter hospitalization (6 vs 8&#xa0;days, <i>p</i> = 0.002). Complication rates trended lower with laparoscopy (8.3% vs 23.8%, <i>p</i> = 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: <i>p</i> = 0.644; OS: <i>p</i> = 0.506). Multivariate analysis confirmed surgical approach did not independently affect prognosis.</p> Conclusions <p>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.</p>

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Laparoscopic resection for gastric gastrointestinal stromal tumor at the esophagogastric junction: feasibility and long-term results

  • 期刊论文

  • 发表日期：

    2026年2月3日

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  • Yi Liao,
  • Jintuan Huang,
  • Hao Chen,
  • Chunyu Chen,
  • Jun Xiang,
  • Zuli Yang

摘要

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.