An experience of video-endoscopic technologies in the treatment of gastric gastrointestinal stromal tumors (GIST)

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.