Retrospective Study
Copyright ©The Author(s) 2021. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastrointest Oncol. Jul 15, 2021; 13(7): 706-715
Published online Jul 15, 2021. doi: 10.4251/wjgo.v13.i7.706
Robotic resection of duodenal gastrointestinal stromal tumour: Preliminary experience from a single centre
Zhi-Peng Zhou, Xiang-Long Tan, Zhi-Ming Zhao, Yuan-Xing Gao, Yu-Yao Song, Yu-Ze Jia, Cheng-Gang Li
Zhi-Peng Zhou, Xiang-Long Tan, Zhi-Ming Zhao, Yuan-Xing Gao, Yu-Yao Song, Yu-Ze Jia, Cheng-Gang Li, Department of Hepato-Pancreato-Biliary Surgery, Chinese PLA General Hospital, Beijing 100853, China
Author contributions: Zhou ZP and Tan XL contributed equally to this work, and are considered co-first authors; Zhou ZP and Tan XL analyzed and interpreted the data and wrote the article; Zhao ZM, Gao YX, Song YY and Jia YZ drafted the work and collected the data; Li CG designed the study and revised the article for important intellectual content.
Institutional review board statement: This study was reviewed and approved by the Ethics Committee of the Chinese PLA General Hospital (approval No. S2016-098-02).
Informed consent statement: All study participants, or their legal guardian, provided informed written consent prior to study enrollment.
Conflict-of-interest statement: All authors declare no conflicts of interest related to this article.
Data sharing statement: No additional data are available.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Cheng-Gang Li, MD, PhD, Associate Professor, Department of Hepato-Pancreato-Biliary Surgery, Chinese PLA General Hospital, No. 28 Fuxing Road, Beijing 100853, China. lcgang301@126.com
Received: March 11, 2021
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
Abstract
BACKGROUND

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.

AIM

To summarize the technique and feasibility of robotic resection of DGISTs.

METHODS

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.

RESULTS

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).

CONCLUSION

Robotic resection is safe and feasible for patients with DGISTs, and its therapeutic effect is equivalent to open surgery.

Keywords: Gastrointestinal stromal tumor, Duodenum, Pancreaticoduodenectomy, Limited resection, Robotic resection

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.