Laparoscopic Endoscopic Cooperative Surgery for Gastrointestinal Stromal Tumors

Wang, Honglei; Cao, Lei; Zheng, Kunming; Zhao, Yan

doi:10.1097/sle.0000000000000591

Cited by 11 publications

(8 citation statements)

References 40 publications

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“…Some hybrid techniques such as laparoscopic endoscopic cooperative surgery (LECS) [11], laparoscopy-assisted endoscopic full-thickness resection (LAEFTR) [12], and nonexposed endoscopic wall-inversion surgery [13] have shown promise. Additionally, robotic surgery [14] may provide the same benefit, but these above-mentioned advantages are not definite.…”

Section: Introductionmentioning

confidence: 99%

Multiband mucosectomy versus endoscopic submucosal dissection and endoscopic submucosal excavation for GI submucosal tumors: short and long term follow-up

Jin

Gai

et al. 2019

BMC Cancer

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Aims To evaluate the short- and long-term outcomes of 3 different endoscopic dissection techniques for upper gastrointestinal (GI) submucosal tumours (SMTs). Methods Data for 135 patients withGI SMTs who underwent multiband mucosectomy (MBM), endoscopic submucosal dissection (ESD), or endoscopic submucosal excavation (ESE) were retrospectively assessed. The en bloc resection rate, endoscopic complete resection rate, operation time, potential complications and local recurrence rate were compared. Results No significant differences were observed in the rate of endoscopic complete resections and pathologic complete resections among the three groups. For SMTs > 15 mm in width, the lowest en bloc resection rate was found for MBM ( P = 0.000). MBM was also associated with the shortest procedure time, lowest perforation rate and lowest rate of major bleeding. ESE was the most effective procedure for muscularis propria (MP) lesions but was associated with the longest operation time ( P < 0.01). The ESD and ESE groups had similar perforation rates ( P > 0.05). No differences were observed in 4-year local recurrence rates among the groups ( P = 0.945). Conclusions MBM is a simple and effective method for the treatment of small SMTs and achieves clinical success rates similar to those of ESD and ESE. However, ESD and ESE are preferable for larger and deep lesions and are associated with a longer operation time. Nonetheless, all 3 techniques resulted in a low 4-year local recurrence rate. Large-scale randomized clinical trials are needed to further investigate these results.

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Section: Introductionmentioning

confidence: 99%

Multiband mucosectomy versus endoscopic submucosal dissection and endoscopic submucosal excavation for GI submucosal tumors: short and long term follow-up

Jin

Gai

et al. 2019

BMC Cancer

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“…Meanwhile, LECS can minimize surgical specimens while still providing sufficient surgical margin to resect gastrointestinal stromal tumors effectively. In addition, LECS operations are not affected by the tumor location, such as EGJ or near the pyloric ring [23]. In a study involving 20 patients by Hironori et al, the success rate of IECS was 100%; there were no postoperative complications and recurrence during postoperative follow-up [24].…”

Section: Discussionmentioning

confidence: 99%

“…Classic LECS must open the stomach wall, so there is a potential risk of stomach contents or tumor cells spilling into the abdominal cavity [23]. With this in mind, researchers have improved classic LECS, these modified LECS, such as Laparoscopy-assisted endoscopic full-thickness resection (LAEFR), a Combination of laparoscopic and endoscopic approaches to neoplasia with a non-exposure technique (CLEAN-NET), inverted LECS, Non-exposed endoscopic wall-inversion surgery (NEWS) and closed LECs can avoid opening the gastric wall and resect the primary GISTS safely and effectively at the same time [23].…”

Section: Discussionmentioning

confidence: 99%

Comparable long-term survival of patients with colorectal or gastric gastrointestinal stromal tumors treated with endoscopic vs. surgical resection

et al. 2021

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Background and aimsWith the development of endoscopic technology, endoscopic treatment has been widely used in Gastrointestinal stromal tumors (GISTs). However, population-based studies comparing the long-term results of patients who received endoscopic treatment vs. Surgery are lacking. We used the Surveillance, Epidemiology, and End Results (SEER) database to analyze the long-term survival of colorectal or gastric GISTs who underwent primary tumor resection (endoscopic therapy or surgery) in the USA. Methods Patients with colorectal or gastric GISTs were selected from the SEER database between 2010 and 2015. Kaplan-Meier analyses and log-rank tests were used to evaluate the difference in the long-term survival between the endoscopic therapy group and the surgery group. We examined the association between different treatments and survival after using the multivariate cox proportional hazards model to adjust the relevant covariates. Besides, we used Propensity score matching (PSM) to overcome the different distributions of covariates between the two groups and then further compare the survival difference. Results In total, 2355 patients were enrolled in our study, of which 1999 (84.9%) received surgical treatment and 356 (15.1%) received endoscopic treatment. There was no significant difference in overall survival (OS) between the two groups before PSM. The median OS (73.5 months vs. 72.2 months) and 5-year OS rate (85.7% vs. 81.5%) of endoscopic therapy were similar to surgical patients (P = 0.34). The median Cancer-specific survival (CSS) and 5-year CSS rate in the endoscopic treatment group were higher than the surgical group before PSM, with 81.3 months, 97.1% versus 78.8 months, 92.7% (P = 0.011). After adjusting for other clinical factors and PSM, the long-term OS and CSS did not significantly differ between those treated surgically and treated endoscopically. Conclusion Based on the American population, we preliminarily found that the long-term OS and CSS did not differ between patients undergoing endoscopic therapy and surgery.

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“…Laparoscopy-and thoracoscopy-assisted endoscopic surgery have been reported as methods to overcome the limitation of the relatively significant invasive nature of MIS and make endoscopic resection less challenging. [7][8][9] When treating early cancer with lymph node metastasis, cancer can be resected under endoscopy, whereas lymph nodes can be resected by laparoscopy. This cooperative application of endoscopy and laparoscopy should be regarded as SMIS.…”

Section: Comparison Between Smis and Mismentioning

confidence: 99%