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Introduction <p>The impact of postoperative and oncologic outcomes between laparoscopic (L) and open (O) surgical approaches for the resection of gastric gastrointestinal stromal tumors (G-GISTs) located in surgically unfavorable regions remains controversial.</p> Materials and methods <p>A retrospective analysis was conducted on 699 patients who underwent primary resection of G-GISTs at surgically unfavorable locations across 14 centers in China between 2001 and 2017. The patients were categorized into L and O surgery groups. To reduce bias due to baseline differences, propensity score matching (PSM) and multivariate Cox proportional hazards models were employed. Postoperative recovery metrics and long-term oncologic outcomes were compared between the matched cohorts.</p> Results <p>After 1:1 PSM, the L group exhibited a significantly shorter and lower postoperative hospital stay, intraoperative estimated blood loss and postoperative complication rate compared to the O group (all <i>P</i> &lt; .010). Kaplan–Meier survival analysis with log-rank testing revealed no statistically significant differences in overall survival (OS) between the two groups (<i>P</i> = .190). Multivariate Cox proportional hazards analysis further indicated that the L approach was not associated with a significant reduction in mortality risk (hazard ratio [HR]: 1.41; 95% confidence interval [CI]: 0.56–3.60; <i>P</i> = .467).</p> Conclusion <p>Laparoscopic resection of G-GISTs located at surgically unfavorable sites was associated with improved short-term postoperative outcomes, including reduced blood loss, shorter hospital stays and fewer complications, compared to open surgery, but had comparable long-term oncologic outcomes.</p>

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Comparison of laparoscopic versus open approach surgery for gastric gastrointestinal stromal tumors in unfavorable surgical locations

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2026年5月14日

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  • Fangyao Zhou,
  • Zhiyuan Liu,
  • Sharvesh Raj,
  • Bin Luo,
  • Kunlong Chang,
  • Jiayuan Zhang,
  • Peng Zhang,
  • Haibo Qiu,
  • Bin Lai,
  • Tao Chen,
  • Wenjun Xiong,
  • Yuan Yin,
  • Xiangbin Wan,
  • Xiufeng Liu,
  • Jian Li,
  • Yan Zhao,
  • Ye Zhou,
  • Junjiang Wang,
  • Yong Li,
  • Xingyu Feng

摘要

Introduction

The impact of postoperative and oncologic outcomes between laparoscopic (L) and open (O) surgical approaches for the resection of gastric gastrointestinal stromal tumors (G-GISTs) located in surgically unfavorable regions remains controversial.

Materials and methods

A retrospective analysis was conducted on 699 patients who underwent primary resection of G-GISTs at surgically unfavorable locations across 14 centers in China between 2001 and 2017. The patients were categorized into L and O surgery groups. To reduce bias due to baseline differences, propensity score matching (PSM) and multivariate Cox proportional hazards models were employed. Postoperative recovery metrics and long-term oncologic outcomes were compared between the matched cohorts.

Results

After 1:1 PSM, the L group exhibited a significantly shorter and lower postoperative hospital stay, intraoperative estimated blood loss and postoperative complication rate compared to the O group (all P < .010). Kaplan–Meier survival analysis with log-rank testing revealed no statistically significant differences in overall survival (OS) between the two groups (P = .190). Multivariate Cox proportional hazards analysis further indicated that the L approach was not associated with a significant reduction in mortality risk (hazard ratio [HR]: 1.41; 95% confidence interval [CI]: 0.56–3.60; P = .467).

Conclusion

Laparoscopic resection of G-GISTs located at surgically unfavorable sites was associated with improved short-term postoperative outcomes, including reduced blood loss, shorter hospital stays and fewer complications, compared to open surgery, but had comparable long-term oncologic outcomes.