Safety analysis of laparoscopic endoscopic cooperative surgery versus endoscopic submucosal dissection for selected gastric gastrointestinal stromal tumors: a propensity score-matched study

Balde, Alpha Ibrahima; Chen, Tao; Hu, Yanfeng; Líu, Hao; Gong, Wei; Yu, Jiang; Li, Zhen; Li, Guoxin

doi:10.1007/s00464-016-5042-3

Cited by 40 publications

(32 citation statements)

References 46 publications

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“…The management of GISTs < 2 cm is controversial; in spite of the fact that an active follow-up of the lesion could be an option, surgery should be considered because there is no data concerning growth behavior and metastasic potential[ 49 , 50 ].…”

Section: Role Of Surgeonmentioning

confidence: 99%

Gastrointestinal stromal tumors: A multidisciplinary challenge

Sánchez-Hidalgo¹,

Durán²,

Molero-Payan³

et al. 2018

WJG

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Gastrointestinal stromal tumors (GISTs) are the most common mesenchymal tumors located in the alimentary tract. Its usual manifestation is gastrointestinal bleeding. However, small asymptomatic lesions are frequently detected as incidental finding. Characteristically, most GISTs (> 95%) are positive for the KIT protein (CD117) by IHC staining and approximately 80%-90% of GISTs carry a mutation in the c-KIT or PDGFRA genes. Mutational analysis should be performed when planning adjuvant and neoadjuvant therapy, due to its possible resistance to conventional treatment. The arise of tyrosine kinase inhibitor has supposed a revolution in GISTs treatment being useful as adjuvant, neoadjuvant or recurrence disease treatment. That is why a multidisciplinary approach to this disease is required. The correct characterization of the tumor at diagnosis (the diagnosis of recurrences and the evaluation of the response to treatment with tyrosine kinase inhibitors) is fundamental for facing these tumors and requires specialized Endoscopist, Radiologists and Nuclear Medicine Physician. Surgery is the only potentially curative treatment for suspected resectable GIST. In the case of high risk GISTs, surgery plus adjuvant Imatinib-Mesylate for 3 years is the standard treatment. Neoadjuvant imatinib-mesylate should be considered to shrink the tumor in case of locally advanced primary or recurrence disease, unresectable or potentially resectable metastasic tumors, and potentially resectable disease in complex anatomic locations to decrease the related morbidity. In the case of Metastatic GIST under Neoadjuvant treatment, when there are complete response, stable disease or limited disease progression, complete cytoreductive surgery could be a therapeutic option if feasible.

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Section: Role Of Surgeonmentioning

confidence: 99%

Gastrointestinal stromal tumors: A multidisciplinary challenge

Sánchez-Hidalgo¹,

Durán²,

Molero-Payan³

et al. 2018

WJG

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“…6 In an institution having well-experienced ESD operators, standard ESD or EMD may be a preferable treatment option for patients with G-SMT originating from Digestive Endoscopy 2018; 30 (Suppl. 1): [7][8][9][10][11][12][13][14][15][16] Endoscopic removal of gastric SMT 13 the MP layer. Moreover, several variations of ESD, such as submucosal endoscopic tumor resection (SET), submucosal tunneling endoscopic resection (STER), endoscopic submucosal tunnel dissection (ESTD), and EFTR without or with laparoscopic assistance have been successfully carried out to remove G-SMT originating from the MP layer.…”

Section: Ost G-smt Including Gist Usually Growmentioning

confidence: 99%

“…These procedures still require evidence of oncological outcomes and remain an investigational treatment . Moreover, little is known about the clinical outcomes of these ER procedures in comparison with those of LR for treating G‐SMT . Therefore, we carried out a retrospective study to compare the two resection methods, namely, ER procedures (ESD, endoscopic muscularis dissection [EMD], and EFTR) and LR.…”

Section: Introductionmentioning

confidence: 99%

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Comparison between endoscopic and laparoscopic removal of gastric submucosal tumor

Abe

Takeuchi

Ohki

et al. 2018

Digestive Endoscopy

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Results: The ER group had a significantly higher percentage of intraluminal growing type of tumor (100% vs 41%) and smaller tumor size (23 vs 33 mm) than the LR group. The ER group had a significantly shorter operative time (93 vs 145 min) and less blood loss (13 vs 30 mL) than the LR group. In the ER group, three patients who had tumors located on the anterior wall of the stomach required laparoscopic closure after EFTR because of difficulty in endoscopic closure of the gastric-wall defect. Postoperative complication rates and duration of postoperative hospital stays did not differ between the two groups.Conclusions: ER may be technically feasible, safe, less invasive, and oncologically appropriate options for selected patients with the intraluminal growing type of G-SMT smaller than 30 mm. EFTR may be more reasonable alternatives to LR in selected patients with a small G-SMT located on the lesser curvature side.

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“…The incidence of complications after gastric GISTs resection is ∼1.8% to 22.7% 22 , 27 , 30 , 33 ; these complications mainly include pulmonary infection, gastrointestinal bleeding, anastomotic stenosis, gastro-esophageal reflux, anastomotic fistula, and delayed gastric emptying. In this study, no postoperative pulmonary infection was observed, which may be related to no placement of nasogastric tube during the perioperative period.…”

Section: Discussionmentioning

confidence: 99%

Robotic Gastrotomy With Intracorporeal Suture for Patients With Gastric Gastrointestinal Stromal Tumors Located at Cardia and Subcardiac Region

Zhao

Wang²,

Jiang³

et al. 2018

Surgical Laparoscopy, Endoscopy &Amp; Percutaneous Techniques

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Purpose:Few studies of robotic gastric gastrointestinal stromal tumors (GISTs) resection have been conducted. This study was aimed to evaluate the robotic gastrotomy with intracorporeal suture for patients with GISTs located at cardia and subcardiac region.Materials and Methods:From January 2014 to August 2016, 11 patients with GISTs located at cardia and subcardiac region underwent robotic gastrotomy with intracorporeal suture. Data of these patients were collected.Results:The mean operative time was 82.7 minutes and the mean blood loss was 30.0 mL. No complication was reported. The postoperative length of stay was 3.3 days. On postoperative day 14, inflammation recovered to preoperative level. On postoperative month 6, the nutritional status was similar to that before the surgery. After 25.5 months follow-up, all patients survived with no recurrence or metastasis.Conclusions:Robotic gastrotomy with intracorporeal suture for patients with GISTs located at cardia and subcardiac region is safe and feasible.

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Safety analysis of laparoscopic endoscopic cooperative surgery versus endoscopic submucosal dissection for selected gastric gastrointestinal stromal tumors: a propensity score-matched study

Abstract: LECS for selected gastric GIST patients is feasible and is associated with a better intraoperative outcome and an equal postoperative course compared with the results of ESD.

Cited by 40 publications

References 46 publications

Gastrointestinal stromal tumors: A multidisciplinary challenge

Gastrointestinal stromal tumors: A multidisciplinary challenge

Comparison between endoscopic and laparoscopic removal of gastric submucosal tumor

Robotic Gastrotomy With Intracorporeal Suture for Patients With Gastric Gastrointestinal Stromal Tumors Located at Cardia and Subcardiac Region

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