The Value Of Endoscopic Therapy For Giant Gastric Stromal Tumor

Objective:Comparative analysis and study on the efficacy and safety of endoscopic treatment of giant gastric stromal tumor,to explore the clinical application value of endoscopic treatment of giant gastric stromal tumor,to summarize experience,and to provide reference for the selection of surgical methods for patients with giant gastric stromal tumor.Methods:Selected seventy-seven patients who were diagnosed with a giant gastric stromal tumor in the Hunan Provincial People’s Hospital from January 2014 to December 2020 and were treated with endoscopic treatment,laparotomy or laparoscopic treatment,which divided into endo scopy group(28 cases),laparotomy group(19 cases)and laparo scopy group(30 cases).And collect the general clinical data,operation-related data,hospitalization expenses,postoperative pathology and follow-up status of each group of patients,compare and analyze the collected data.Results:1.There was no significant difference in age,gender,symptoms of first visit,gastroscopy detection rate,and CT detection rate of patients in the endoscopy group,laparotomy group,and laparoscopy group(P>0.05).2.The three groups had no statistically significant differences in the surgical success rate,complete resection rate,tumor growth pattern,tumor shape,and postoperative hospital stay(P>0.05)in the endoscopic group,laparotomy group,and laparoscopic group.There was no statistically significant tumor size in the endoscopic group,laparotomy group,and laparoscopic group,which is the difference(3.95±0.62 cm VS3.99±0.29 cm VS 4.09±0.70 cm,P>0.05).The operation time of the endoscopic group was shorter than that of the laparotomy group and the laparoscopic group(111.14±38.01 min VS 197.63±35.24 min VS 194.67±59.58 min,P<0.05).The intraoperative bleeding of the endoscopic group was shorter than that of the laparotomy group and the laparoscopic group(9.46±8.00 ml VS 57.37±21.30 ml VS 34.83±11.93 ml,P<0.01).There were differences in tumor location between the three groups(P<0.05).The proportion of the tumor in the fundus of the stomach in the endoscopic group was 57.14%,which was significantly higher than the average level of 40.26%,and the proportion of the gastric antrum in the open group 15.79%,which is significantly higher than the average level of 10.39%;the proportion of gastric body in the open-laparotomy group is 63.16%,which is significantly higher than the average level of 41.56%,and the proportion of gastric body in the laparoscopic group is 46.67%,which is significantly higher than the average level of 41.56%;and the endoscopic group had obvious postoperative complications less than the laparotomy group and laparoscopic group(P<0.01);the median hospitalization cost of the endoscopy group was significantly lower than that of the lapar otomy group and laparoscopic group(35102.77 yuan VS42536.24 yuan VS 61863.04 yuan,P<0.05).3.The three groups had no significant differences in tumor pathology,risk,and immunochemical chemistry(P>0.05),and no resid ual or recurrence was found in the follow-up of patients in the three groups.Conclusions:For patients with giant gastric stromal tumor,endoscopic treatment is safe and effective.The operation time,intraoperative bleeding,postoperative complications,first meal time and cost of the endoscopic group are significantly lower than those of laparotomy and laparoscopic patients,the success rate was similar in all three groups.