Comparison Analysis of Three Different Types of Minimally Invasive Procedures for Gastrointestinal Stromal Tumors ≤5cm

Objective: This study aimed to evaluate the safety, feasibility, and prognosis of three different types of minimally invasive procedures for treating gastric gastrointestinal stromal tumors (GISTs) <= 5cm. Materials and Methods: The clinical data, perioperative conditions, and the follow-up results of patients who underwent laparoscopic resection (LAP), laparoscopic and endoscopic cooperative surgery (LECS), or endoscopic submucosal dissection (ESD) for gastric GISTs <= 5cm were retrospectively collected and analyzed. Results: A total of 91 patients were enrolled in this study, and the number of cases who underwent LAP, LECS, and ESD was 30, 15, and 46, respectively. Compared with patients in the LAP and LECS group, patients in the ESD group had a smaller tumor size (P<.001, <.05, respectively.) and a higher percentage of intragastric growth pattern (all P value <.01). Significant differences were found in operative time and intraoperative blood loss among the three groups (P<.001). The operative time and intraoperative blood loss in ESD group were significantly less than that in LECS and LAP groups. No statistical difference was found in the postoperative recovery and complications among the three groups, such as nasogastric tube retention, anal exhaust time, oral intake, postoperative complication, and tumor recurrence. Conclusions: Minimally invasive surgery for gastric GISTs <= 5cm is safe and feasible. The final choice regarding a minimally invasive approach should be based on the tumor size, tumor location, pattern of tumor growth, and experience of laparoscopic surgeons.