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Trends and outcomes of minimally invasive surgery for gastrointestinal stromal tumors (GIST)

  • 2021 SAGES Oral
  • Published:
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Abstract

Objective

Minimally invasive surgery (MIS) is increasingly being utilized for the resection of gastrointestinal cancers. National trends for perioperative and oncologic outcomes of MIS for gastrointestinal stromal tumors (GIST) are unknown. We hypothesized that with increased use of MIS, the perioperative outcomes and survival for GIST are preserved.

Methods

The National Cancer Database (2010–2016) was utilized to assess perioperative and oncologic outcomes for GIST of the stomach and small bowel. Kaplan–Meier method and log rank test were used to compare survival outcomes.

Results

Data from 8923 gastric and 3683 small bowel resections were analyzed. Over the study period, MIS became the prevalent modality for gastrectomies (2010: robotic: 2.4%, laparoscopic: 26.1%, open: 71.5% vs. 2016: robotic: 9.6%, laparoscopic: 48.8%, open: 41.6%; p < 0.001), with a smaller increase in enterectomies (2010: robotic: 1%, laparoscopic: 17.3%, open: 81.6% vs. 2016: robotic: 3.9%, laparoscopic: 27.2%, open: 68.9%; p < 0.001). Age and Charlson comorbidity index were similar among groups. MIS approaches were associated with fewer readmissions and lower 90 day mortality for gastrectomies and similar rates for enterectomies. MIS did not compromise patient survival even in patients who underwent neoadjuvant treatment or harbored tumors ≥ 10 cm.

Conclusion

Minimally invasive surgery is increasingly being utilized for resection of gastric and small bowel GIST, with improved postoperative outcomes. In this retrospective review, overall survival after minimally invasive or open surgery was comparable, even in challenging scenarios of neoadjuvant treatment or large tumors (≥ 10 cm).

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Acknowledgements

The authors would like to thank Katherine Aguirre, PhD for editing the manuscript

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Authors and Affiliations

  1. Department of Surgery, Texas Tech University Health Sciences Center, El Paso, TX, USA

    Jonathan Gevorkian, Emily Le, Brian Davis, Alan Tyroch, Shintaro Chiba & Ioannis T. Konstantinidis

  2. Biostatistics and Epidemiology and Consulting Lab, Office of Research, Texas Tech University Health Sciences Center, El Paso, TX, USA

    Luis Alvarado

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  1. Jonathan Gevorkian
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  2. Emily Le
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  3. Luis Alvarado
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  4. Brian Davis
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  5. Alan Tyroch
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  6. Shintaro Chiba
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  7. Ioannis T. Konstantinidis
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Correspondence to Ioannis T. Konstantinidis.

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Disclosures

Dr. Shintaro Chiba serves as Proctor for Intuitive Surgical. Jonathan Gevorkian, Emily Le, Luis Alvarado, Brian Davis, Alan Tyroch, and Ioannis T Konstantinidis have no conflicts of interest or financial ties to disclose.

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Gevorkian, J., Le, E., Alvarado, L. et al. Trends and outcomes of minimally invasive surgery for gastrointestinal stromal tumors (GIST). Surg Endosc 36, 6841–6850 (2022). https://doi.org/10.1007/s00464-022-09014-2

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  • DOI: https://doi.org/10.1007/s00464-022-09014-2

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