Endoscopy-assisted laparoscopic intervention enhanced intraoperative and postoperative outcomes and improved postoperative nutritional and coagulation profiles of patients with gastrointestinal stromal tumors (GISTs) compared to traditional laparoscopic procedures, according to findings published in the Journal of Oncology.
Researchers enrolled 126 patients with resectable GISTs in their study between November 2016 and May 2020. They divided the patients into 2 groups—those who underwent laparoscopic gastrectomy (n=63) and those who underwent endoscopy-assisted laparoscopic gastrectomy (n=63).
Patients who underwent endoscopy-assisted laparoscopic gastrectomies spent less time in surgery compared with those in the laparoscopic cohort (81.21±10.24 minutes vs 98.98±15.31 minutes). They also had less intraoperative bleeding (18.74±6.98 ml vs 58.69±15.87 ml) and smaller surgical incisions (3.63±1.12 cm vs 5.01±1.14 cm).
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Compared to patients in the laparoscopic gastrectomy group, patients in the endoscopy-assisted gastrectomy group demonstrated shorter hospital stays (7.05±1.31 vs 10.56±1.97), decreased duration of drainage and gastric tube use (1.62±0.52 vs 3.48±0.96), and decreased time to first postoperative exhaustion (2.73±1.02 vs 5.33±2.04).
The minimally invasive surgical group demonstrated a significantly lower incidence of postoperative complications compared with the laparoscopic group (3.17% vs 25.39%). These postoperative complications included incisional infections, gastrointestinal dysfunction, gastric fistulas, and abdominal infections.
Following surgery, the endoscopic group demonstrated improved coagulation profiles compared with the laparoscopic group, including lower prothrombin (10.48±0.68 vs 11.97±0.46) and higher fibrinogen (0.67±0.11 vs 0.29±0.07) levels.
Compared with the laparoscopic group, the endoscopic group also exhibited improved nutritional status 3 days after surgery with higher prealbumin (0.12±0.03 ng/L vs 0.07±0.02 ng/L), transferrin (0.68±0.13 ng/L vs 0.51±0.11 ng/L), and albumin (7.92±1.02 g/L vs 7.03±1.24 g/L) levels.
“Endoscopy-assisted laparoscopic treatment shows significant improvements in the efficiency of minimally invasive surgery and ensures a better prognosis and quality of life of patients with a good safety profile, so it is worthy of clinical application,” the authors concluded.
Liu L, Dai A. Endoscopy-assisted laparoscopic versus laparoscopic surgery for gastrointestinal stromal tumor and the impact on patients’ coagulation, surgical condition, and complications. J Oncol. 2022;2022:e6847321. doi:10.1155/2022/6847321