Abstract:ObjectiveTo study the safety and effectiveness of endoscopic fullthickness resection(EFR) in the treatment of large gastric stromal tumors with diameter of 57 cm. MethodsData of 36 patients with large gastric stromal tumors (57 cm) who received EFR or surgery (including laparoscopic and open surgery) in the First Affiliated Hospital of Zhengzhou University and confirmed by postoperative histopathology from January 2017 to October 2018 were retrospectively analyzed. Patients were divided into endoscopic group (9 cases) and surgical group (27 cases) according to different resection methods. The perioperative indicators and the total incidence of complications in the two groups were compared. ResultsIn terms of perioperative indicators, the median operation time of the endoscopic group was significantly longer than that of the surgical group (40 hours VS 20 hours, P<001), and the postoperative fasting time (455±088 days VS 622±224 days, t=-215, P=003) and hospital stay (688±126 days VS 1003±290 days, t=-313, P<001) were significantly shorter than those of the surgical group. The median visual analogue scores (VAS) of abdominal pain of the endoscopic group on the first postoperative day (3 VS 6, P<001)and the third postoperative day (1 VS 3, P<001) were significantly lower than those of the surgical group. The hospitalization cost was significantly less than that of the surgical group (55±147 thousand yuan VS 73±243 thousand yuan, t=-211, P=004). In term of the total incidence of complications, the endoscopic group was 111% (1/9), which was higher than that of the surgical group [74% (2/27)], but there was no statistically significant difference(P=100). ConclusionEFR is safe and effective in the treatment of large gastric stromal tumors (57 cm), and has the advantages of less invasiveness, rapid postoperative recovery, and lower hospitalization cost. But how to shorten the operation time is an urgent problem to be solved.