Laparoscopic and endoscopic cooperative surgery is a safe and feasible procedure for the treatment of gastric gastrointestinal stromal tumors (GIST), according to a new study published in Endoscopy International Open. The authors said that the procedure is safe “despite several oncological concerns.”

The oncological safety of the procedure for gastric GIST remains unclear despite the fact that it has been widely used in Asian countries for the treatment of gastric submucosal tumors. This is because it is associated with potential oncology-related problems, which may have a negative impact on patient survival. Moreover, the feasibility and safety of the procedure were unclear.

In the present study, a team of researchers from Tokyo, Japan retrospectively analyzed the completion of the procedure, complications, and survival outcomes in 215 patients who were scheduled to undergo laparoscopic and endoscopic cooperative surgery between 2006 and 2020 to treat their gastric GIST. 


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Of these 215 patients, 213 completely underwent laparoscopic and endoscopic cooperative surgery. This corresponds to a completion rate of 99.1 %. Six patients had complications following the operation, with delayed gastric emptying being the most common, which was seen in 4 patients. Patients with complications were more commonly older and female, and they often had a large tumor located in the lesser curvature.

The researchers calculated that the 3-year overall survival rate of the patients was 99%, while the disease-specific survival rate was 100 %.

“In conclusion, [laparoscopic and endoscopic cooperative surgery] is a feasible and perioperatively safe procedure for gastric GIST that has appropriate indications in terms of location and size,” the researchers wrote.

They also said that the postoperative surveillance methods recommended in the guidelines might need to be changed to consider the highly curable nature of gastric GIST when removed using laparoscopic and endoscopic cooperative surgery.

Reference

Harada H, Ohashi M, Hiki N, et al. Excellent oncological outcomes besides short-term safety of laparoscopic and endoscopic cooperative surgery for gastric gastrointestinal stromal tumor. Endosc Int Open. 2022;10(9):E1254-E1260. doi:10.1055/a-1895-9507