Published online Jul 15, 2021. doi: 10.4251/wjgo.v13.i7.706
Peer-review started: March 11, 2021
First decision: April 19, 2021
Revised: April 19, 2021
Accepted: June 4, 2021
Article in press: June 4, 2021
Published online: July 15, 2021
Processing time: 121 Days and 2.5 Hours
Experience in minimally invasive surgery in the treatment of duodenal gastrointestinal stromal tumors (DGISTs) is accumulating, but there is no consensus on the choice of surgical method.
To summarize the technique and feasibility of robotic resection of DGISTs.
The perioperative and demographic outcomes of a consecutive series of patients who underwent robotic resection and open resection of DGISTs between May 1, 2010 and May 1, 2020 were retrospectively analyzed. The patients were divided into the open surgery group and the robotic surgery group. Pancreatoduodenectomy (PD) or limited resection was performed based on the location of the tumour and the distance between the tumour and duodenal papilla. Age, sex, tumour location, tumour size, operation time (OT), estimated blood loss (EBL), postoperative hospital stay (PHS), tumour mitosis, postoperative risk classification, postoperative recurrence and recurrence-free survival were compared between the two groups.
Of the 28 patients included, 19 were male and 9 were female aged 51.3 ± 13.1 years. Limited resection was performed in 17 patients, and PD was performed in 11 patients. Eleven patients underwent open surgery, and 17 patients underwent robotic surgery. Two patients in the robotic surgery group underwent conversion to open surgery. All the tumours were R0 resected, and there was no significant difference in age, sex, tumour size, operation mode, PHS, tumour mitosis, incidence of postoperative complications, risk classification, postoperative targeted drug therapy or postoperative recurrence between the two groups (P > 0.05). OT and EBL in the robotic group were significantly different to those in the open surgery group (P < 0.05). All the patients survived during the follow-up period, and 4 patients had recurrence and metastasis. No significant difference in recurrence-free survival was noted between the open surgery group and the robotic surgery group (P > 0.05).
Robotic resection is safe and feasible for patients with DGISTs, and its therapeutic effect is equivalent to open surgery.
Core Tip: Minimally invasive surgery for the treatment of duodenal gastrointestinal stromal tumors (DGISTs) has made rapid progress. More and more cases of DGISTs treated by robotic surgery have been reported. The results of this study suggest that robotic resection of DGISTs is safe and effective, and can be carried out in experienced medical centres.