Department of General Surgery, Ege University, İzmir, Turkey.
Department of General Surgery, Ege University Hospital, İzmir, Turkey.
Turk J Gastroenterol. 2024 Mar 4;35(3):193-203. doi: 10.5152/tjg.2024.24080.
Gastrointestinal stromal tumors (GISTs), the most common mesenchymal tumors in the gastrointestinal tract, are increasingly treated with minimally invasive surgeries. Developed techniques include laparoscopic, endoscopic, and hybrid methods for gastric GIST resection. Our study, focusing on single-incision laparoscopic intragastric resection for gastric GISTs, aims to evaluate its safety, efficacy, and long-term outcomes. In a retrospective study of GIST surgery involving 14 patients who underwent single-incision laparoscopic intragastric resections, we analyzed and compared their preoperative demographics, American Society of Anesthesiologists (ASA) scores, tumor size, neoadjuvant treatment, operation duration, hospital stay, mitotic and Ki-67 indexes, and histological features with those of patients who underwent open and laparoscopic wedge resections, to assess the impact on both survival and disease-free survival. Average operation time was 93.07 minutes (range 81-120 minutes). Average blood loss: 67 ± 20 mL (range 40-110 mL). Postoperative hospital stay averaged 6.79 days (range 4-16 days). Strong correlations were observed between preoperative and pathological tumor sizes (P = .001, P < .001). Survival analysis indicated a significant association with ASA scores (P = .031), but not with mitotic index, Ki-67, or tumor size. Average survival was 80.57 months, with no recurrence or metastasis during follow-up. Based on our experience, the single-incision laparoscopic intragastric resection method emerges as a highly efficient, timesaving, and gentle oncological procedure, providing a safe and minimally invasive alternative resulting in shorter hospital stays and excellent long-term outcomes with minimal recurrence. For more definitive conclusions, larger, multicenter, and prospective studies are recommended.
胃肠道间质瘤（GISTs）是胃肠道最常见的间叶源性肿瘤，越来越多地采用微创外科手术治疗。已开发的技术包括腹腔镜、内镜和混合方法用于胃 GIST 切除。我们的研究专注于单切口腹腔镜胃内切除胃 GIST，旨在评估其安全性、疗效和长期结果。在一项涉及 14 例接受单切口腹腔镜胃内切除术的 GIST 手术的回顾性研究中，我们分析并比较了他们的术前人口统计学、美国麻醉医师协会（ASA）评分、肿瘤大小、新辅助治疗、手术时间、住院时间、有丝分裂和 Ki-67 指数以及组织学特征与接受开放和腹腔镜楔形切除术的患者，以评估对生存和无病生存的影响。平均手术时间为 93.07 分钟（范围 81-120 分钟）。平均出血量：67±20mL（范围 40-110mL）。术后住院时间平均为 6.79 天（范围 4-16 天）。术前和病理肿瘤大小之间存在很强的相关性（P=0.001，P<0.001）。生存分析表明与 ASA 评分显著相关（P=0.031），但与有丝分裂指数、Ki-67 或肿瘤大小无关。平均生存时间为 80.57 个月，随访期间无复发或转移。根据我们的经验，单切口腹腔镜胃内切除方法是一种高效、省时、温和的肿瘤学方法，提供了一种安全且微创的替代方法，导致住院时间更短，长期结果极佳，复发率极低。为了得出更明确的结论，建议进行更大、多中心和前瞻性研究。
