Minimally invasive surgery for gastric gastrointestinal stromal tumors

Koh, Ye‐Xin; Goh, Brian K. P.

doi:10.21037/tgh.2017.11.20

Cited by 13 publications

(10 citation statements)

References 40 publications

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“…For localized primary GISTs, radical resection, including open surgical resection and minimally invasive techniques, were selected as the primary treatments ( 19 ). Minimally invasive techniques included laparoscopic surgery, endoscopic surgery and endoscopy-assisted laparoscopic surgery ( 20 , 21 ). For locally advanced unresectable or metastatic GISTs, palliative surgery and/or imatinib treatment were recommended, and imatinib adjuvant therapy following radical resection was recommended for patients with intermediate-to-high-risk GISTs ( 22 ).…”

Section: Methodsmentioning

confidence: 99%

Clinicopathological characteristics and prognostic factors of gastrointestinal stromal tumors in Chinese patients

et al. 2018

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Gastrointestinal stromal tumors (GISTs) are the most common mesenchymal neoplasms in the gastrointestinal tract, exhibiting wide variability in their biological behavior. The aim of the present study was to investigate the clinicopathological characteristics and prognostic factors of GISTs in Chinese patients. All GIST cases (n=182) retrieved from the pathology database and the archived files in Shanghai Changzheng Hospital between January 2011 and December 2014 were reviewed. The clinical symptoms, preoperative investigations, treatments, pathological characteristics and follow-up data of these patients were reviewed, and univariate and multivariate survival analyses were performed. A total of 73.1% of the GISTs were located in the stomach, and the most common three symptoms included abdominal pain (30.2%), dyspepsia (23.1%) and gastrointestinal bleeding (21.4%). Univariate analysis revealed that larger tumor size (P<0.001), higher mitotic rate (P<0.001), aggressive behavior (P<0.001), negative smooth muscle actin expression (P=0.009) and palliative resection (P<0.001) contributed toward poor overall survival (OS). In addition, non-gastric disease location (P<0.001), larger tumor size (P<0.001), higher mitotic rate (P=0.004), aggressive behavior (P<0.001) and palliative resection (P<0.001) were associated with poor relapse-free survival (RFS). Multivariate analysis indicated that mitotic rate [hazard ratio (HR=3.761, P=0.015)] and aggressive behavior (HR=3.916, P=0.010) were independent risk factors for OS, while non-gastric location (HR=4.740, P=0.002) and aggressive behavior (HR=4.009, P=0.004) were independent risk factors for RFS. The present study provided information on the clinicopathological characteristics and epidemiology of GISTs in the Chinese population. Non-gastric disease location, higher mitotic rate and tumor metastasis or local invasion prior to treatment were identified as predictors of a poor prognosis.

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Section: Methodsmentioning

confidence: 99%

Clinicopathological characteristics and prognostic factors of gastrointestinal stromal tumors in Chinese patients

et al. 2018

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“…Gastrointestinal stromal tumours (GIST) are localized more frequently in the stomach. Laparoscopic approach for gastric GIST represents a worldwide accepted treatment option 1 . Still, only a few retrospective studies comparing laparoscopy with the traditional open techniques have been published.…”

Section: Introductionmentioning

confidence: 99%

Open versus laparoscopic versus robotic gastric gastrointestinal stromal tumour resections: A multicentre cohort study

Solaini

Cavaliere

Fico

et al. 2020

Robotics Computer Surgery

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Purpose To present the outcomes of gastric gastrointestinal stromal tumour (GIST) resection from five Italian centres, focussing the analysis on the comparison among open (OG), laparoscopic (LG) and robotic (RG) approaches. Methods All consecutive gastric wedge resections for GIST between 2009 and 2019 were included. Results In total 101 (OG = 14, LG = 63 and RG = 24) were included. No differences were seen in the preoperative characteristics among the groups. Robotic procedures were longer (RG 180 min vs. LG 100 vs. OG 110; p < 0.0001). Time‐to‐first flatus and length of hospital stay were significantly longer in the OG group. Complication rates were similar among the groups. A sub‐analysis on minimally invasive (RG = 19 vs. LG = 20) wedge resections and hand/robot‐sewn suture showed that operative time was longer in the RGs (p = 0.007). No conversions were recorded in the RG group versus three in the LG group (p = 0.231). Safety‐related factors were similar. Conclusions Gastric GIST can be safely treated with a minimally invasive approach which is also associated with improved postoperative outcomes.

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“…Tumour rupture should be avoided as much as possible during DGIST resection because it is a high-risk factor for postoperative recurrence and metastasis [3,5,[7][8][9][10][11]. Tumours located in the horizontal segment of the duodenum are often closely related to the superior mesenteric vein and superior artery.…”

Section: Discussionmentioning

confidence: 99%

“…The resection methods of DGIST include limited resection and pancreatoduodenectomy (PD), which should be determined according to the location of the tumour, the relationship between the tumour and the duodenal papilla, and whether the tumour invades the surrounding tissues. The indications for minimally invasive surgery, such as laparoscopic and robotic resection, have been expanding in treatment for DGIST in recent years [9,10]. Laparoscopic or robotic resection can be performed according to the location and size of the tumour in an experienced medical centre.…”

Section: Introductionmentioning

confidence: 99%

Robotic Resection of Duodenal Gastrointestinal Stromal Tumour: Preliminary Experience from a Single Centre

Zhou

Tan

Zhao

et al. 2021

Preprint

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Background: The experience of minimally invasive surgery in the treatment of duodenal gastrointestinal stromal tumours (DGISTs) is accumulating, but there is no consensus on the choice of surgical method. The purpose of this study is to summarize the technique and feasibility of robotic resection of DGIST.Methods: The demographics and perioperative outcomes of a consecutive series of patients who underwent robotic resection and open resection of DGIST between May 1, 2010 and May 1, 2020 were retrospectively analysed. Patients were divided into an open surgery group and a robotic surgery group. Pancreaticoduodenectomy (PD) or limited resection was performed based on the location of the tumour and the distance between the tumour and duodenal papilla. Age, sex, tumour location, tumour size, operation time (OT), estimated blood loss (EBL), postoperative hospital stay (PHS), tumour mitosis, postoperative risk classification, postoperative recurrence and recurrence-free survival were compared between the two groups.Results: Among the 28 patients, there were 19 males and 9 females aged 51.3± 13.1 years. Limited resection was performed in 17 patients, and PD was performed in 11 patients. Eleven patients underwent open surgery, and 17 patients underwent robotic surgery. Two patients in the robotic surgery group underwent conversion to open surgery. All the tumours were R0 resected, and there was no significant difference in age, sex, tumour size, operation mode, PHS, tumour mitosis, incidence of postoperative complications, risk classification, postoperative targeted drug therapy or postoperative recurrence between the two groups (p>0.05). OT and EBL in the robotic group were significantly different from those in the open surgery group (p<0.05). All the patients survived during the follow-up period, and 4 patients had recurrence and metastasis. No significant difference in recurrence-free survival was noted between the open surgery group and the robotic surgery group (p>0.05).Conclusions: Robotic resection is safe and feasible for patients with duodenal gastrointestinal stromal tumours, and its therapeutic effect is equivalent to open surgery.

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Minimally invasive surgery for gastric gastrointestinal stromal tumors

Cited by 13 publications

References 40 publications

Clinicopathological characteristics and prognostic factors of gastrointestinal stromal tumors in Chinese patients

Clinicopathological characteristics and prognostic factors of gastrointestinal stromal tumors in Chinese patients

Open versus laparoscopic versus robotic gastric gastrointestinal stromal tumour resections: A multicentre cohort study

Robotic Resection of Duodenal Gastrointestinal Stromal Tumour: Preliminary Experience from a Single Centre

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