Comparative Study Of Laparoscopy And Laparotomy In The Treatment Of Gastric Stromal Tumors (≥5cm And ≤10cm)

Objective:To compare the clinical efficacy of laparoscopy and laparotomy in the treatment of gastric stromal tumors(≥5cm and ≤10cm)and explore the feasibility,efficacy and safety of laparoscopic surgery in gastric stromal tumors greater than 5cm.Methods:This study retrospectively analyzed the clinical data of patients with gastric stromal tumors in our hospital from January 2008 to January 2017.All of these cases were confirmed by pathoiogy.The size of tumors was between 5-10 cm.According to the surgical method,we divided those patients into laparoscopy group and laparotomy group.There were 40 cases in laparoscopy group,while 40 cases in laparotomy group.Dates of those patients including age,sex,BMI,tumor size,the dangerous degree,operation time,intraoperative blood lose,postoperative exhaust time,surgical complications,length of hospitalization,disease-free survival and 5-year survival rate were analyzed by SPSS 20.0 statistical software.Subgroup analysis was applied to compare the difference between open surgery and laparoscopic surgery in different regions and different growth modes.Results:There was no significant difference in age,gender,BMI,tumor size,and risk grade between the laparoscopic group and the laparotomy group(P>0.05).The data of two groups were comparable.The operation time of laparoscopic group was longer than the laparotomy group,and the difference was statistically significant(P=0.049).However,the laparoscopic group was less than the laparotomy group in terms of postoperative venting time,postoperative eating time,and postoperative hospital stay,the difference between two groups was statistically significant(P<0.05).The results of subgroup analysis showed that gastric stromal tumors which grew at favorable locations or outside of gastric will obtain less intraoperative bleeding,shorter postoperative exhaust time and shorter length of hospitalization after laparoscopic surgery,the difference was statistically significant(P < 0.05).However,there was no significant difference between the two groups in the operation time(P > 0.05).Conclusion:Laparoscopic surgery is safe and effective for ≥ 5cm and ≤ 10 cm gastric stromal tumors.Compared to laparotomy,laparoscopic surgery has the advantages of less trauma and faster recovery.The advantage will be more obvious when selecting the cases of favorable location or exogenous growth.