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Laparoscopic Versus Open Surgery for Rectal Gastrointestinal Stromal Tumor: A Multicenter Propensity Score-Matched Analysis.

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机构： [1]Department of Gastrointestinal Surgery, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China [2]Department of Gastrointestinal Surgery, Renji Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China [3]Department of General Surgery, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing, China [4]Department of Gastrointestinal Surgery, Peking University People’s Hospital, Beijing, China [5]Department of Colorectal Surgery, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union College, Beijing, China [6]Department of General Surgery, the First Affiliated Hospital of Shandong First Medical University, Jinan, China [7]Department of Digestive Surgery, Xijing Hospital of Digestive Diseases, The Fourth Military Medical University, Xi’an, China [8]Department of Gastric Surgery, Liaoning Cancer Hospital and Institute, Cancer Hospital of China Medical University, Shenyang, China [9]Department of Gastrointestinal Surgery, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China [10]Department of Gastrointestinal Surgery, Hubei Cancer Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China [11]Department of Gastrointestinal Surgery, West China Hospital, Sichuan University, Chengdu, China

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The safety and feasibility of laparoscopic surgery for the management of rectal gastrointestinal stromal tumors are unknown.To compare the surgical and oncologic results of laparoscopic versus open surgery for the treatment of rectal gastrointestinal stromal tumors.Retrospective multicenter propensity score-matched study to minimize heterogeneity between groups and focus on the difference between surgery strategies.Eleven Chinese tertiary hospitals participated in this study.A total of 364 patients with pathologically confirmed rectal gastrointestinal stromal tumors were retrospectively analyzed.Relapse-free survival, postoperative hospital stay length, and 30-day postoperative complication rate.We enrolled 214 patients who underwent surgical operation for primary localized rectal gastrointestinal stromal tumors. After propensity score matching, 134 cases involved in the comparison (67 laparoscopic vs. 67 open surgery) were randomly matched (1:1) by sex, age, tumor size, tumor site, and neoadjuvant therapy. The laparoscopic surgery group had superior relapse-free survival (χ2 = 4.46, p = 0.04), and fewer complications (6.0% vs. 25.4%, p = 0.002). No significant difference was found in the length of postoperative hospital stay between the laparoscopic surgery and open surgery groups (9.66 ± 5.42 vs. 10.64 ± 4.93, p = 0.28). Subgroup analysis showed that the laparoscopic surgery group had superior relapse-free survival (χ2 = 4.14, p = 0.04) and fewer complications after surgery (2.9% vs. 24.4%, p = 0.01) in the rectal gastrointestinal stromal tumors ≤ 5 cm subgroup.The nature of retrospective review and relatively short follow-up period are limitations of this study.Laparoscopic surgery offers a safe and feasible option for the radical resection of primary localized rectal gastrointestinal stromal tumors, especially for patients with rectal gastrointestinal stromal tumors ≤ 5 cm. See Video Abstract at http://links.lww.com/DCR/B764.Copyright © 2021 The American Society of Colon and Rectal Surgeons.

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出版当年[2021]版：

大类 | 2 区医学

小类 | 2 区胃肠肝病学 2 区外科

最新[2023]版：

大类 | 2 区医学

小类 | 2 区外科 3 区胃肠肝病学

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第一作者机构： [1]Department of Gastrointestinal Surgery, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China

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通讯机构： [1]Department of Gastrointestinal Surgery, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China [11]Department of Gastrointestinal Surgery, West China Hospital, Sichuan University, Chengdu, China [*1]Department of Gastrointestinal Surgery, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, no. 1277 Jiefang Avenue, Wuhan 430022, Hubei Province, China. [*2]Department of Gastrointestinal Surgery, West China Hospital, Sichuan University, no. 37 Guoxue Lane, Chengdu, 610041, Sichuan Province, China.

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