Endoscopic versus laparoscopic resection of gastrointestinal stromal tumors at the esophagogastric junction using propensity score matching analysis
Abstract The esophagogastric junction (EGJ) has a complex anatomy and critical physiological functions, making postoperative quality of life an important consideration in the surgical resection of gastrointestinal stromal tumors at this location (EGJ-GISTs). We conducted a propensity score-matched (...
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Nature Portfolio
2025-05-01
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| Online Access: | https://doi.org/10.1038/s41598-025-98859-3 |
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| author | Shanshan Zhu Zhen Liu Jingwen Zhang Nan Dai Saif Ullah Ge Zhang Shengang Zhang Ping Liu Yang Fu Shimeng Zheng Zhaokai Zhou Yudi Xu Le Chang Changqing Guo Xinguang Cao |
| author_facet | Shanshan Zhu Zhen Liu Jingwen Zhang Nan Dai Saif Ullah Ge Zhang Shengang Zhang Ping Liu Yang Fu Shimeng Zheng Zhaokai Zhou Yudi Xu Le Chang Changqing Guo Xinguang Cao |
| author_sort | Shanshan Zhu |
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| description | Abstract The esophagogastric junction (EGJ) has a complex anatomy and critical physiological functions, making postoperative quality of life an important consideration in the surgical resection of gastrointestinal stromal tumors at this location (EGJ-GISTs). We conducted a propensity score-matched (1:1) analysis to compare the safety and efficacy of endoscopic resection (ER) and laparoscopic resection (LR) for patients with EGJ-GIST treated at the First Affiliated Hospital of Zhengzhou University, China, from December 2013 to November 2023. We reviewed 176 patients (ER 82; LR 94) with EGJ-GIST, of whom 85 patients with a tumor size of 2–5 cm met the matching criteria (ER 42; LR 43), yielding 20 pairs of patients. ER showed advantages over LR, with a shorter postoperative nil per os time (4.0 days (IQRs, 3.0–5.0) vs. 5.5 days (IQRs, 4.3–7.8), p = 0.005) and postoperative hospitalization time (6.0 days (IQRs, 5.0−6.8) vs. 8.5 days (IQRs, 6.0−11.8, p = 0.002). Long-term adverse events were significantly lower in the ER group (15% vs. 55%, p = 0.005). No recurrence or metastasis was observed in either group during a mean follow-up of 42.3 months. These findings suggest that for 2–5 cm EGJ-GISTs, ER is a safe and effective alternative, offering minimal invasiveness, faster recovery, fewer complications, and improved long-term quality of life. |
| format | Article |
| id | doaj-art-8ab0699515f046ae86e770dfb431c1b5 |
| institution | OA Journals |
| issn | 2045-2322 |
| language | English |
| publishDate | 2025-05-01 |
| publisher | Nature Portfolio |
| record_format | Article |
| series | Scientific Reports |
| spelling | doaj-art-8ab0699515f046ae86e770dfb431c1b52025-08-20T02:15:28ZengNature PortfolioScientific Reports2045-23222025-05-0115111010.1038/s41598-025-98859-3Endoscopic versus laparoscopic resection of gastrointestinal stromal tumors at the esophagogastric junction using propensity score matching analysisShanshan Zhu0Zhen Liu1Jingwen Zhang2Nan Dai3Saif Ullah4Ge Zhang5Shengang Zhang6Ping Liu7Yang Fu8Shimeng Zheng9Zhaokai Zhou10Yudi Xu11Le Chang12Changqing Guo13Xinguang Cao14Department of Gastroenterology, The First Affiliated Hospital of Zhengzhou UniversityDepartment of Gastroenterology, The First Affiliated Hospital of Zhengzhou UniversityDepartment of Gastroenterology, The First Affiliated Hospital of Zhengzhou UniversityDepartment of Gastroenterology, The First Affiliated Hospital of Zhengzhou UniversityDepartment of Gastroenterology, The First Affiliated Hospital of Zhengzhou UniversityDepartment of Cardiology, The First Affiliated Hospital of Zhengzhou UniversityCollege of Veterinary Medicine, Henan Agricultural UniversityDepartment of Gastroenterology, The First Affiliated Hospital of Zhengzhou UniversityDepartment of Gastrointestinal Surgery, The First Affiliated Hospital of Zhengzhou UniversityDepartment of Gastroenterology, The First Affiliated Hospital of Zhengzhou UniversityDepartment of Pediatric Urology, The First Affiliated Hospital of Zhengzhou UniversityDepartment of Neurology, The First Affiliated Hospital of Zhengzhou UniversityDepartment of Gastroenterology, The Fifth Affiliated Hospital of Zhengzhou UniversityDepartment of Gastroenterology, The First Affiliated Hospital of Zhengzhou UniversityDepartment of Gastroenterology, The First Affiliated Hospital of Zhengzhou UniversityAbstract The esophagogastric junction (EGJ) has a complex anatomy and critical physiological functions, making postoperative quality of life an important consideration in the surgical resection of gastrointestinal stromal tumors at this location (EGJ-GISTs). We conducted a propensity score-matched (1:1) analysis to compare the safety and efficacy of endoscopic resection (ER) and laparoscopic resection (LR) for patients with EGJ-GIST treated at the First Affiliated Hospital of Zhengzhou University, China, from December 2013 to November 2023. We reviewed 176 patients (ER 82; LR 94) with EGJ-GIST, of whom 85 patients with a tumor size of 2–5 cm met the matching criteria (ER 42; LR 43), yielding 20 pairs of patients. ER showed advantages over LR, with a shorter postoperative nil per os time (4.0 days (IQRs, 3.0–5.0) vs. 5.5 days (IQRs, 4.3–7.8), p = 0.005) and postoperative hospitalization time (6.0 days (IQRs, 5.0−6.8) vs. 8.5 days (IQRs, 6.0−11.8, p = 0.002). Long-term adverse events were significantly lower in the ER group (15% vs. 55%, p = 0.005). No recurrence or metastasis was observed in either group during a mean follow-up of 42.3 months. These findings suggest that for 2–5 cm EGJ-GISTs, ER is a safe and effective alternative, offering minimal invasiveness, faster recovery, fewer complications, and improved long-term quality of life.https://doi.org/10.1038/s41598-025-98859-3Esophagogastric junctionGastrointestinal stromal tumorEndoscopic resectionLaparoscopic resectionPropensity score matching |
| spellingShingle | Shanshan Zhu Zhen Liu Jingwen Zhang Nan Dai Saif Ullah Ge Zhang Shengang Zhang Ping Liu Yang Fu Shimeng Zheng Zhaokai Zhou Yudi Xu Le Chang Changqing Guo Xinguang Cao Endoscopic versus laparoscopic resection of gastrointestinal stromal tumors at the esophagogastric junction using propensity score matching analysis Scientific Reports Esophagogastric junction Gastrointestinal stromal tumor Endoscopic resection Laparoscopic resection Propensity score matching |
| title | Endoscopic versus laparoscopic resection of gastrointestinal stromal tumors at the esophagogastric junction using propensity score matching analysis |
| title_full | Endoscopic versus laparoscopic resection of gastrointestinal stromal tumors at the esophagogastric junction using propensity score matching analysis |
| title_fullStr | Endoscopic versus laparoscopic resection of gastrointestinal stromal tumors at the esophagogastric junction using propensity score matching analysis |
| title_full_unstemmed | Endoscopic versus laparoscopic resection of gastrointestinal stromal tumors at the esophagogastric junction using propensity score matching analysis |
| title_short | Endoscopic versus laparoscopic resection of gastrointestinal stromal tumors at the esophagogastric junction using propensity score matching analysis |
| title_sort | endoscopic versus laparoscopic resection of gastrointestinal stromal tumors at the esophagogastric junction using propensity score matching analysis |
| topic | Esophagogastric junction Gastrointestinal stromal tumor Endoscopic resection Laparoscopic resection Propensity score matching |
| url | https://doi.org/10.1038/s41598-025-98859-3 |
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