A Systematic Review and Meta-Analysis Comparing Laparoscopic Versus Open Gastric Resections for Gastrointestinal Stromal Tumors of the Stomach

Koh, Ye‐Xin; Aik-Yong, Chok; Zheng, Huili; Tan, Chuen Seng; Chow, Pierce K. H.; Wong, Wai‐Keong; Goh, Brian K. P.

doi:10.1245/s10434-013-3051-1

Cited by 118 publications

(91 citation statements)

References 40 publications

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“…(5,6) However, the adoption of laparoscopic surgery in the fields of liver and pancreatic surgery has been relatively slow. (7,8) Although the first laparoscopic liver and pancreatic resections were reported in the early 1990s, (9,10) widespread adoption of such operations has been hindered by the technical complexities of these procedures, and concerns about oncological margins and risk of bleeding.…”

Section: Introductionmentioning

confidence: 99%

First experience with robotic spleen-saving, vessel-preserving distal pancreatectomy in Singapore: a report of three consecutive cases

Goh

Wong

Chan

et al. 2016

smedj

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INTRODUCTIONOver the past few decades, the use of laparoscopic surgery has expanded rapidly to become the surgical approach of choice for many abdominal operations, including cholecystectomies, (1) appendicectomies, (2) adrenalectomies,colectomies (4) and gastric resections.(5,6) However, the adoption of laparoscopic surgery in the fields of liver and pancreatic surgery has been relatively slow. (7,8) Although the first laparoscopic liver and pancreatic resections were reported in the early 1990s, (9,10) widespread adoption of such operations has been hindered by the technical complexities of these procedures, and concerns about oncological margins and risk of bleeding. (8) Pancreatic surgery is among the most complex and challenging of all abdominal operations.(11) Despite rapid surgical advancements, pancreatic surgery remains a challenge and is associated with a high morbidity rate worldwide, even in highly specialised and experienced tertiary centres.(12,13) Laparoscopic pancreatic surgery was first reported by Cuschieri in 1994.(9) Since then, a growing number of studies on laparoscopic pancreatic surgeries have been published, although it has yet to gain widespread acceptance.(11) As distal pancreatectomy (DP) is not as technically demanding as pancreaticoduodenectomy, it is not surprising that most of the published studies are on the outcomes of laparoscopic DP (LDP). (14) These early studies have reported the potential benefits of using the laparoscopic approach, including decreased pain and blood loss, faster recovery, and a shorter hospital stay; the laparoscopic approach is also associated with morbidity rates that are similar to those observed with the use of the open approach. (14,15) Despite the increased adoption of LDP, there are barriers to its widespread adoption, which include the significant risk of conversion to the hand-assisted or open approach. (15,16) Robotic surgery was introduced to overcome the shortcomings of conventional laparoscopic surgery. (11,15,17) The robotic platform provides a three-dimensional, high-definition, magnified view of the operative field. It also provides the additional advantages of improved dexterity and precision due to increased freedom of movement and the elimination of tremors. (7,11) The superiority of robotic surgery over conventional laparoscopy when performing complex surgical tasks has been proven in ex vivo models. (15) However, its use in the clinical setting remains controversial, especially with regard to DP. In the first series of robotic distal pancreatectomies (RDPs), reported by Giulianotti et al in 2003, 13 patients underwent RDP. (18) Several studies on RDP have since been reported, most of which were small case series involving less than 50 patients. (17)

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Section: Introductionmentioning

confidence: 99%

First experience with robotic spleen-saving, vessel-preserving distal pancreatectomy in Singapore: a report of three consecutive cases

Goh

Wong

Chan

et al. 2016

smedj

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“…The National Comprehensive Cancer Network Clinical Practice Guidelines for Optimal Management of Patients with GIST states that a laparoscopic approach should be reserved for tumors <2 cm. However, studies report this technique being used for tumors 2.7 -6.0 cm with low recurrence rates and margin negativity suggests that a large tumor size should not be an absolute contraindication to laparoscopic resection [64]. For GISTs > 5 cm, the use of an endobag may be used to protect the exophytic lesion from lacerations [65].…”

Section: Laparoscopic Surgery Principlesmentioning

confidence: 99%

“…A recent meta-analysis reviewed laparoscopic vs. gastric resections for the treatment of 765 patients with gas-tric GISTs [64]. As would be expected, a higher proportion of high-risk tumors and gastrectomies were performed by open technique in comparison with laparoscopic gastric resection.…”

Section: Localized Gists 1) Gastric Gistsmentioning

confidence: 99%

Gastrointestinal Stromal Tumors in the 21<sup>st</sup> Century

Kanthan¹,

Senger²,

Ahmed³

et al. 2014

JCT

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Gastrointestinal stromal tumours (GISTs) are rare mesenchymal lesions accounting for only 0.2% of all gastrointestinal neoplasms. These tumors arise from the interstitial cells of Cajal, with mutations described in proto-oncogenes such as KIT, PDGFRA, DOG-1, and SDH. The majority of these lesions are asymptomatic, thus the true incidence remains unknown. While patients typically undergo initial endoscopy, CT scan and/or MRI, findings are often nonspecific and require a biopsy to identify the tumor. As such, immunohistochemical evaluation is the gold-standard for the accurate diagnosis of GIST. Though surgical excision remains the gold-standard for curative management, the discovery of imatinib, a tyrosine kinase inhibitor (TKI), has revolutionized the treatment of GIST in the 21 st century as a "prototype" of molecular targeted therapy for solid tumors. Risk assessment for recurrence divides these tumors into low and high-risk categories. In the latter, a role for adjuvant therapy with TKI confers a significantly better prognosis than previously observed. However, secondary mutations conferring drug resistance remain an ongoing challenge for management, as few alternative treatment options are available for patients intolerant/refractory to TKI therapy. In this review, we summarize the epidemiology, molecular pathogenesis, clinical presentation, diagnosis, pathology features, management options, and prognostic features of GISTs.

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“…Today, in many tertiary centres, laparoscopic surgery is performed on an almost routine basis for abdominal surgical procedures such as appendectomy, (1) cholecystectomy, (2,3) adrenalectomy, (4,5) gastric resection (6) and colectomy. (7) However, the adoption of laparoscopy in hepatectomies has been limited until the last decade, despite the widespread use of laparoscopy in many abdominal procedures; (8) this is due to the technical complexity of the procedure, and concerns regarding the adequacy of oncological margins and the risk of bleeding.…”

Section: Introductionmentioning

confidence: 99%

Robotic hepatectomy: initial experience of a single institution in Singapore

Kam

Goh

Chan

et al. 2016

smedj

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A Systematic Review and Meta-Analysis Comparing Laparoscopic Versus Open Gastric Resections for Gastrointestinal Stromal Tumors of the Stomach

Abstract: LR results in superior short-term postoperative outcomes without compromising oncological safety and long-term oncological outcomes compared with OR.

Cited by 118 publications

References 40 publications

First experience with robotic spleen-saving, vessel-preserving distal pancreatectomy in Singapore: a report of three consecutive cases

First experience with robotic spleen-saving, vessel-preserving distal pancreatectomy in Singapore: a report of three consecutive cases

Gastrointestinal Stromal Tumors in the 21<sup>st</sup> Century

Robotic hepatectomy: initial experience of a single institution in Singapore

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A Systematic Review and Meta-Analysis Comparing Laparoscopic Versus Open Gastric Resections for Gastrointestinal Stromal Tumors of the Stomach

Abstract: LR results in superior short-term postoperative outcomes without compromising oncological safety and long-term oncological outcomes compared with OR.

Cited by 118 publications

References 40 publications

First experience with robotic spleen-saving, vessel-preserving distal pancreatectomy in Singapore: a report of three consecutive cases

First experience with robotic spleen-saving, vessel-preserving distal pancreatectomy in Singapore: a report of three consecutive cases

Gastrointestinal Stromal Tumors in the 21&lt;sup&gt;st&lt;/sup&gt; Century

Robotic hepatectomy: initial experience of a single institution in Singapore

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Product

Resources

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Gastrointestinal Stromal Tumors in the 21<sup>st</sup> Century