胃间质瘤的微创治疗方法：多中心机器人手术和腹腔镜手术经验分析及文献综述

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

作者信息

Ceccarelli Graziano, Costa Gianluca, De Rosa Michele, Codacci Pisanelli Massimo, Frezza Barbara, De Prizio Marco, Bravi Ilaria, Scacchi Andrea, Gallo Gaetano, Amato Bruno, Bugiantella Walter, Tacchi Piergiorgio, Bartoli Alberto, Patriti Alberto, Cappuccio Micaela, Komici Klara, Mariani Lorenzo, Avella Pasquale, Rocca Aldo

机构信息

General Surgery Department, ASL 2 Umbria, San Giovanni Battista Hospital, 06034 Foligno, Italy.

General, Minimally Invasive and Robotic Surgery, Department of Surgery, ASL 2 Umbria, San Matteo Hospital, 06049 Spoleto, Italy.

出版信息

Cancers (Basel). 2021 Aug 27;13(17):4351. doi: 10.3390/cancers13174351.

: 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 ( = 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.

胃肠道间质瘤（GISTs）最常发生于胃部。在多学科治疗模式下，手术是最佳治疗选择，主要术式为胃楔形切除术。（1）材料与方法：2010年1月至2020年9月期间，105例原发性胃部胃肠道间质瘤（GISTs）患者在三个外科单位接受了手术。（2）结果：对来自3个转诊中心的81例（36例腹腔镜手术和45例机器人手术）微创系列病例进行了多机构分析。男性35例（43.2%），平均年龄66.64岁。RS组中ASA评分≥3分的有6例（13.3%），LS组有4例（11.1%），平均肿瘤大小为4.4 cm。大多数手术为楔形切除术（n = 76；93.8%），RS组主要手术时间为151分钟，LS组为97分钟。5例（6.2%）需要中转开腹。（3）结论：在选定的患者和经验丰富的中心对胃GISTs采用微创方法是安全可行的。机器人手术是一种有效的选择，尤其适用于直径大于5 cm的GISTs，即使肿瘤位于不利位置。