Minimal Access Surgery for the Treatment of Gastric Gastrointestinal Stromal Tumours - A Single Centre Experience

Stanciulea, Oana; Ionescu, M; Blanita, Diana; Lacatus, Monica; Gheorghe, Cristian; Vasilescu, C

doi:10.21614/chirurgia.115.6.726

Cited by 4 publications

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“…Laparoscopy should be taken into account in patients with smaller tumors in more favorable positions, while robotic surgery may be more effective for larger tumors in more difficult surgical fields. To the date, due to the small number of retrospective studies on robotic approach to GGS, it is not possible to draw definitive conclusions [64,65].…”

Section: Discussionmentioning

confidence: 99%

Minimally Invasive Approach to Gastric GISTs: Analysis of a Multicenter Robotic and Laparoscopic Experience with Literature Review

Ceccarelli

Costa

Rosa

et al. 2021

Cancers

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Background: Gastrointestinal stromal tumors (GISTs) are most frequently located in the stomach. In the setting of a multidisciplinary approach, surgery represents the best therapeutic option, consisting mainly in a wedge gastric resection. (1) Materials and methods: Between January 2010 to September 2020, 105 patients with a primary gastrointestinal stromal tumor (GISTs) located in the stomach, underwent surgery at three surgical units. (2) Results: A multi-institutional analysis of minimally invasive series including 81 cases (36 laparoscopic and 45 robotic) from 3 referral centers was performed. Males were 35 (43.2%), the average age was 66.64 years old. ASA score > 3 was 6 (13.3%) in the RS and 4 (11.1%) in the LS and the average tumor size was 4.4 cm. Most of the procedures were wedge resections (N = 76; 93.8%) and the main operative time was 151 min in the RS and 97 min in the LS. Conversion was necessary in five cases (6.2%). (3) Conclusions: Minimal invasive approaches for gastric GISTs performed in selected patients and experienced centers are safe. A robotic approach represents a useful option, especially for GISTs that are more than 5 cm, even located in unfavorable places.

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Section: Discussionmentioning

confidence: 99%

Minimally Invasive Approach to Gastric GISTs: Analysis of a Multicenter Robotic and Laparoscopic Experience with Literature Review

Ceccarelli

Costa

Rosa

et al. 2021

Cancers

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“…Despite tyrosine kinase inhibitors such as imatinib are currently the treatment of choice for metastatic or recurrent GISTs, surgical resection is still considered the first choice in cases concerning nonmetastatic resectable tumors. The goal of the surgery is to achieve complete resection with free margins, and lymphadenectomy is usually not necessary 1 , 6 , 26 , 29 .…”

Section: Introductionmentioning

confidence: 99%

“…When, initially, characterization of a GIST is the intention, it is considered that simply labeling the tumor as benign or malignant may not be the most appropriate approach, as even small tumors with low mitotic counts can sometimes metastasize and have malignant potential. Therefore, GISTs risk stratification (very low, low, intermediate, or high) seems to be more appropriate, with the variables considered as predictors of aggressive clinical behavior being tumor size 5 cm or larger and a mitotic index of at least 5 mitoses/50 HPF (high-power field) 10 , 14 , 15 , 26 .…”

Section: Introductionmentioning

confidence: 99%

Laparoscopic Versus Open Surgery in Gastric Gastrointestinal Stromal Tumors Larger Than 5 Cm: A Systematic Review and Meta-Analysis

Araujo

Barbosa

Martins

et al. 2022

ABCD, arq. bras. cir. dig.

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BACKGROUND: Surgical resection represents the main treatment for resectable nonmetastatic gastric gastrointestinal stromal tumors. Despite the feasibility and safety of laparoscopic resection, its standard use in gastric tumors larger than 5 cm is yet to be established. AIMS: This study aimed to compare the current evidence on laparoscopic resection with the classical open surgical approach in terms of perioperative, postoperative, and oncological outcomes. METHODS: The PubMed, Scopus, and Web of Science databases were consulted. Articles comparing the approach to gastric gastric gastrointestinal stromal tumors larger than 5 cm by open and laparoscopic surgery were eligible. A post hoc subgroup analysis based on the extent of the surgery was performed to evaluate the operative time, blood loss, and length of hospital stay. RESULTS: A total of nine studies met the eligibility criteria. In the study, 246 patients undergoing laparoscopic surgery and 301 patients undergoing open surgery were included. The laparoscopic approach had statistically significant lower intraoperative blood loss (p=0.01) and time to oral intake (p<0.01), time to first flatus (p<0.01), and length of hospital stay (0.01), compared to the open surgery approach. No significant differences were found when operative time (0.25), postoperative complications (0.08), R0 resection (0.76), and recurrence rate (0.09) were evaluated. The comparative subgroup analysis between studies could not explain the substantial heterogeneity obtained in the respective outcomes. CONCLUSION: The laparoscopic approach in gastric gastrointestinal stromal tumors larger than 5 cm compared to the open surgical approach is a technically safe and feasible surgical method with similar oncological results.

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“…Ancak, ş md ye kadar standart b r terapot k yaklaşım hakkında f k r b rl ğ yoktur. GIST cerrah s nde genel olarak komplet cerrah rezeks yon yapı-lab ld ğ sürece, m n mal nvaz f cerrah g derek popülar te kazanmaktadır [15][16][17]. Uygun end kasyonlarda ve yeterl deney m varlığında, lokal zasyon ve r sk grubundan bağımsız olarak laparoskop öner lmekted r 18,19.…”

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Gastrointestinal Stromal Tümörlerin Kliniko-patolojik ve Cerrahi Özellikleri: 13 yıllık 3.Basamak Merkezi Deneyimi ve Literatür Derlemesi

Akın

HARMANTEPE

Akkaya

et al. 2023

Sakarya Medical Journal

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Amaç: Gastrointestinal stromal tümörler (GIST) sindirim sisteminin en sık görülen mezenkimal kaynaklı tümörleridir. Bu çalışmada cerrahi tedavi uygulanmış olan GIST hastalarının erken dönem cerrahi sonuçları sunulmaktadır. Materyal-Metod: Sakarya Üniversitesi Eğitim Araştırma Hastanesi Genel Cerrahi Kliniğinde 2008-2021 tarihleri arasında opere edilen ve histopatolojik olarak GIST tanısı doğrulanan hastaların sonuçları retrospektif olarak incelendi. Hastalar demografik veriler, klinik-patolojik özellikleri ve erken dönem cerrahi sonuçları açılarından ayrıntılı olarak değerlendirildi. Bulgular: Ameliyat edilen 55 hastanın E/K oranı 3/2, yaş ortalaması 57.82 yıl (45-81 yıl) idi. Karın ağrısı (37 hasta - %67.2) en sık başvuru şikayetiydi. Mide (37 hasta - %67.2) en sık etkilenen organdı. CD117 pozitifliği 53 hastada (%96.3) oranında görüldü ve Ulusal Sağlık Enstitüsü (NIH) kategorisine göre hastaların %56.6’sı yüksek risk sınıfı olarak kategorize edildi. 52 hastaya (%94.6) primer cerrahi rezeksiyon uygulandı. En sık açık ameliyat 40 hastada (%72,7) tercih edildi, çalışmanın son 6 yılı için ise açık/laparoskopi tercih edilme oranı 1/1 olarak belirlendi. Segmental rezeksiyon 29 hastayla (%52,7) açık veya laparoskopik en sık uygulanan rezeksiyon tipi idi. Tümör boyutları ortalama 7.03 cm (1-18 cm), ortalama hastanede yatış süresi 10.44 gün (5-45 gün) idi, enterokütan fistül gelişen bir hasta çalışma dışı bırakıldığında ise ortalama hastane yatış süresi 8.2 gün (5-19 gün) olarak belirlendi. Sonuç: GIST, uygun endikasyonlarda açık veya laparoskopik teknikle primer tedavi şekli komplet cerrahi rezeksiyon olarak deneyimli kliniklerde kabul edilebilir komplikasyon oranlarıyla güvenle tedavi edilebilir.

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Minimal Access Surgery for the Treatment of Gastric Gastrointestinal Stromal Tumours - A Single Centre Experience

Cited by 4 publications

References 0 publications

Minimally Invasive Approach to Gastric GISTs: Analysis of a Multicenter Robotic and Laparoscopic Experience with Literature Review

Minimally Invasive Approach to Gastric GISTs: Analysis of a Multicenter Robotic and Laparoscopic Experience with Literature Review

Laparoscopic Versus Open Surgery in Gastric Gastrointestinal Stromal Tumors Larger Than 5 Cm: A Systematic Review and Meta-Analysis

Gastrointestinal Stromal Tümörlerin Kliniko-patolojik ve Cerrahi Özellikleri: 13 yıllık 3.Basamak Merkezi Deneyimi ve Literatür Derlemesi

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