AN EXPERIENCE OF VIDEO-ENDOSCOPIC TECHNOLOGIES IN THE TREATMENT OF GASTRIC GASTROINTESTINAL STROMAL TUMORS (GIST)
https://doi.org/10.17238/issn2072-3180.2021.2.5-11
Abstract
Objective: To study the results of surgical treatment of gastrointestinal stromal tumors of the stomach using minimally invasive methods of treatment.
Materials and methods: The clinical observation group consisted of 37 patients. There were 12 males (32.3%) and 25 females (67.7%). The median age was 53.4±11.2 years. In 23 (12.9%) patients, the tumor was originated from the muscle plate of the gastric mucosa, and in 14 — from the muscle layer of the gastric wall. The size of the tumor was varied from 2 to 10 cm. Submucosal tumor dissection (ESD) was performed in 10 patients, laparoscopic partial gastric resection — in 8, and robot – assisted partial gastric resection — in 19 patients.
Results: The average duration of video endoscopic operations was 135.8±15.5 minutes. In robotic interventions, the average duration of docking in 2017 was 33.2±3.4, in 2018 – 26.4±2.2, in 2019 – 21.7±1.6, and in 2020 — 19.5±1.4 minutes. Intraoperative complication in the form of perforation of the gastric wall with submucosal dissection of the tumor was noted in 1 (10%) case. Complications in the postoperative period were observed in 1 (3.2%) patient.
Conclusion: Tumors taking place from the muscle plate of the mucous membrane without involving the muscle membrane of the stomach with a size of 2 to 5 cm are subject to endoscopic removal by the method of submucosal dissection. For tumors larger than 2 cm with involvement of the gastric mucosa, the most preferred method of removal is laparoscopic or robotic partial resection.
About the Authors
A. V. Shabunin
Department of Surgery, Russian Medical Academy of Continuous Professional Education; Botkin Memorial Hospital
Russian Federation
Russian Federation
Shabunin Alexei Vasilievich - Doctor of Physics, Professor, corresponding member; Chief surgeon; Head of the Department of
surgery; Chief physician
Moscow, 2nd Bitlinskiy pr., 5, Moscow, 125284
D. N. Grekov
Department of Surgery, Russian Medical Academy of Continuous Professional Education; Botkin Memorial Hospital
Russian Federation
Russian Federation
Grekov Dmitry Nikolaevich - PhD in Physics, Associate professor; Deputy chief physician (oncology)
3, Moscow, 117593, Russia
V. N. Yakomaskin
Botkin Memorial Hospital
Russian Federation
Russian Federation
Yakomaskin Viktor Nikolaevich - Department head
Inzhenernayast., 8A, Moscow, 127410
A. A. Kuzmenko
Botkin Memorial Hospital
Russian Federation
Russian Federation
Kuzmenko Alexander Alexandrovich - Oncologist of the Department of Oncosurgery No. 72
GeroyevPanfilovcevst., 1, Moscow, 125373
M. Z. Eminov
Department of Surgery, Russian Medical Academy of Continuous Professional Education; Botkin Memorial Hospital
Russian Federation
Russian Federation
Eminov Makhir Ziyadovich - Associate professor at the Department of surgery
Leningradskoye highway, 106, Moscow, 125190
A. Kh. Sultygov
Botkin Memorial Hospital
Russian Federation
Russian Federation
Sultygov Ahmed Khasmagamedovich - Surgeon of the Department of Planned Surgery No. 77
Marshala Zhukovast., 46, Moscow, 123154
M. V. Petrishin
Botkin Memorial Hospital
Russian Federation
Russian Federation
Petrishin Mikhail Valerievich - Surgeon
Nemanskiy pr, 13-2, Moscow, 123592
References
1. Saafan T. Gastric GIST. Gastric Cancer - An Update [Internet]. IntechOpen, 2019, Mar., 20. http://dx.doi.org/10.5772/intechopen.77297
2. Вogomolov N.I., Pakholchuk P.P., Tomskikh N.N., Goncharov A.G., Goncharova M.A., Golyakova A.S. Effektivnost’ hirurgicheskogo lecheniya bol’nyh s lokalizovannymi stromal’nymi opuholyami zheludochno-kishechnogo trakta [Gastrointestinal stromal tumors (gist): diagnosis and treatment]. Acta Biomedica Scientifica (East Siberian Biomedical Journal), 2017, 2(6), рр. 52–58. (In Russ.) https://doi.org/10.12737/article_5a0a856cd0a467.14225823
3. Christopher L. Corless and Michael C. Heinrich. Stromal’nye opuholi zheludochno-kishechnogo trakta (giso): opyt diagnostiki i lecheniya [Molecular Pathobiology of Gastrointestinal Stromal Sarcomas]. Annual Review of Pathology: Mechanisms of Disease, 2008, 3, рр. 557–586. https://doi.org/10.1146/annurev.pathmechdis.3.121806.151538
4. Christopher L. Corless and Michael C. Heinrich. Molecular Pathobiology of Gastrointestinal Stromal Sarcomas. Annual Review of Pathology: Mechanisms of Disease, 2008, 3, рр. 557–586. https://doi.org/10.1146/annurev.pathmechdis.3.121806.151538
5. Casali P.G., Abecassis N., Aro H.T., Bauer S., Biagini R., Bielack S., Bonvalot S., Boukovinas I., Bovee JVMG, Brodowicz T., Broto J.M., Buonadonna A., De Álava E., Dei Tos A.P., Del Muro X.G., Dileo P., Eriksson M., Fedenko A., Ferraresi V., Ferrari A., Ferrari S., Frezza A.M., Gasperoni S., Gelderblom H., Gil T., Grignani G., Gronchi A., Haas R.L., Hassan B., Hohenberger P., Issels R., Joensuu H., Jones R.L., Judson I., Jutte P., Kaal S., Kasper B., Kopeckova K., Krákorová D.A., Le Cesne A., Lugowska I., Merimsky O., Montemurro M., Pantaleo M.A., Piana R., Picci P., Piperno-Neumann S., Pousa A.L., Reichardt P., Robinson M.H., Rutkowski P., Safwat A.A., Schöffski P., Sleijfer S., Stacchiotti S., Sundby Hall K., Unk M., Van Coevorden F., van der Graaf W.T.A., Whelan J., Wardelmann E., Zaikova O., Blay J.Y.; ESMO Guidelines Committee and EURACAN. Gastrointestinal stromal tumours: ESMO-EURACAN Clinical Practice Guidelines for diagnosis, treatment and follow-up. Ann Oncol., 2018, Oct, 1, 29 (Suppl 4), рр. 68–78. https://doi.org/10.1093/annonc/mdy095
6. Demetri G.D., Benjamin R.S., Blanke C.D., Blay J.Y., Casali P., Choi H., Corless C.L., Debiec-Rychter M., DeMatteo R.P., Ettinger D.S., Fisher G.A., Fletcher C.D., Gronchi A., Hohenberger P., Hughes M., Joensuu H., Judson I., Le Cesne A., Maki R.G., Morse M., Pappo A.S., Pisters P.W., Raut C..P, Reichardt P., Tyler D.S., Van den Abbeele A.D., von Mehren M., Wayne .JD., Zalcberg J. NCCN Task Force. NCCN Task Force report: management of patients with gastrointestinal stromal tumor (GIST)--update of the NCCN clinical practice guidelines. J. Natl. Compr. Canc. Netw., 2007, Jul., 5, Suppl. 2, рр. 1–29.
7. Nguyen S.Q., Divino C.M., Wang J.L. et al. Laparoscopic management of gastrointestinal stromal tumors. Surg. Endosc., 2006, 20, рр. 713–716. https://doi.org/10.1007/s00464-005-0435-8
8. Hirokazu Kiyozaki, Masaaki Saito, Hirofumi Chiba, Osamu Takata, Toshiki Rikiyama. Laparoscopic wedge resection of the stomach for gastrointestinal stromal tumor (GIST): non-touch lesion lifting method. Gastric Cancer, 2014, 17, рр. 337–340 https://doi.org/10.1007/s10120-013-0272-8
9. Novitsky Y.W., Kercher K.W., Sing R.F., Heniford B.T. Long-term outcomes of laparoscopic resection of gastric gastrointestinal stromal tumors. Ann. Surg., 2006, Jun., 243(6), рр. 738–747. https://doi.org/10.1097/01.sla.0000219739.11758.27
10. Nishimura, J., Nakajima, K., Omori, T., Takahashi, T., Nishitani, A., Ito, T. and Nishida, T. (2007) Surgical Strategy for Gastric Gastrointestinal Stromal Tumors: Laparoscopic vs. Open Resection. Surgical Endoscopy, 2007, 21, рр. 875–878. https://doi.org/10.1007/s00464-006-9065-z
11. Tao K.X., Wan W.Z., Chen J.H., Yang W.C., Cai M., Shuai X.M., Cai K.L., Gao J.B., Wang G.B., Zhang P. [Laparoscopic versus open surgery for gastric gastrointestinal stromal tumors in unfavorable location: a propensity score-matching analysis]. Zhonghua Wai Ke Za Zhi., 2019, Aug, 1, 57(8), рр. 585–590. Chinese. https://doi.org/10.3760/cma.j.issn.0529-5815.2019.08.005
12. Ortenzi M., Ghiselli R., Cardinali L., Guerrieri M. Surgical treatment of gastric stromal tumors: laparoscopic versus open approach. Ann. Ital. Chir., 2017, 88, S0003469X17026112.
13. Shi F., Li Y., Pan Y., Sun Q., Wang G., Yu T., Shi C., Li Y., Xia H., She J. Clinical feasibility and safety of third space robotic and endoscopic cooperative surgery for gastric gastrointestinal stromal tumors dissection: A new surgical technique for treating gastric GISTs. Surg. Endosc., 2019, Dec., 33(12), рр. 4192–4200. https://doi.org/10.1007/s00464-019-07223-w
Review
For citations:
Shabunin A.V., Grekov D.N., Yakomaskin V.N., Kuzmenko A.A., Eminov M.Z., Sultygov A.Kh., Petrishin M.V. AN EXPERIENCE OF VIDEO-ENDOSCOPIC TECHNOLOGIES IN THE TREATMENT OF GASTRIC GASTROINTESTINAL STROMAL TUMORS (GIST). Moscow Surgical Journal. 2021;(2):5-11. (In Russ.) https://doi.org/10.17238/issn2072-3180.2021.2.5-11
Views:
588
Email this article 