GASTROINTESTINAL STROMAL TUMORS OF THE UPPER GASTROINTESTINAL TRACT SURGERY: PROSPECTIVE TWO-CENTER RANDOMIZED TRIAL

Background: Gastrointestinal stromal tumors (GISТ) have recently been of the greatest interest among tumors of the gastrointestinal tract of mesenchymal origin due to the complete absence of a specific clinical picture. Surgical tactics in the treatment of GISO patients is the main one and does not raise any doubts, but, despite this, there are many controversial issues in choosing the optimal nature and scope of surgical treatment for localized and locally common forms of GISТ.

Aim: is to evaluate and compare the results of treatment of patients with GISТ of the upper gastrointestinal tract using open and laparoscopic surgery.

Materials and methods: The basis of the work is the results of the examination and treatment of 68 GIS patients of various age groups observed from 2012 to 2018. The study was performed in the form of a prospective two-center randomized patient with an assessment of the results of diagnosis and treatment. The first group consisted of 33 patients who underwent traditional surgical surgery, the second - 35 patients who underwent laparoscopic surgery. Postoperative complications were evaluated on a Clavien-Dindo scale.

Results: Lethal outcomes in group I and group II were not observed. When assessing postoperative complications, it was revealed that in group II complications of the I and III b degree on the Clavien-Dindo scale are 2 times less than in group I. In group I, 4 (12.1%) complications of the IIIb degree on the Clavien-Dindo scale and 2 (6.0%) complication of the first degree on the Clavien-Dindo scale (the total share of complications was 18.1%), and in group II only 2 (5.7%) complications of the III b degree on the Clavien-Dindo scale were revealed. The time for performing atypical gastric and bowel resection in group II compared with group I is 1,3 and 1,1 times less, respectively, but when performing pancreato-duodenal resections in group I, the results are better than in group II - in 1,25 times.

Conclusions. Minimally invasive surgical interventions for GISТ of the upper gastrointestinal tract are associated with a shorter time of surgical intervention, the amount of blood loss during surgery and a reduction in the patient’s hospital stay.

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