Advancement in Technology and its Benefits in Gastrointestinal Stromal Tumours Resections
EAES Academy. Chaudhury M. 07/05/22; 366546; P289
Dr. Madhu Chaudhury
Contributions
Contributions
Abstract
Aim: Our unit has been involved in removing Gastrointestinal stromal tumours (GISTs) for over 10 years. Recent technological advances and the inception of Robotic surgery has allowed us to achieve difficult local excisions successfully which would otherwise prove challenging.
With the development of robotic surgery, the DaVinci robot has allowed the surgeon to perform precise wedge resection with high definition 3D visualisation and instruments with endowrist technology.
This study was to see the difference in Length of Stay (LoS) comparing the three different techniques which includes Open vs Laparoscopic vs Robotic.
Methods: We looked at case notes retrospectively of all the gastric GISTs excised from 2011-2021. The database comprised of open, laparoscopic and robotic cases amongst 5 surgeons. Where case notes were unavailable, those were removed from data collection. LoS of the complete hospital admission was observed between the different techniques, open vs laparoscopic vs robotic. This was statistically assessed using Mann-Whitney U test on SPSS v22.
Results: We performed 88 GIST resection cases. 19 (22%) cases were open, 61(69%) cases were laparoscopic and 8 (9%) cases were robotic in our Upper GI unit. The median age of the patients was 59 (range 48-82) years. The median LoS for Open was 9 (range 5-19) days, for laparoscopic it was 7 (range 5-12) days and for robotic 5 (range 2-9) days. Our data suggested significant difference in the LoS between the 3 groups. Tumour negative margins were accomplished in all case notes reviewed. The table attached shows the p-values.
Conclusion: Our data shows that with the advent of robotic technology, there is a significant reduction in the total LoS between the different techniques. In addition, our robotic surgery data suggests gastric GIST can be removed successfully from challenging anatomical locations avoiding radical excision such as gastrectomy. This may help reduce the need for HDU admission and improves functional outcome.
Methods: We looked at case notes retrospectively of all the gastric GISTs excised from 2011-2021. The database comprised of open, laparoscopic and robotic cases amongst 5 surgeons. Where case notes were unavailable, those were removed from data collection. LoS of the complete hospital admission was observed between the different techniques, open vs laparoscopic vs robotic. This was statistically assessed using Mann-Whitney U test on SPSS v22.
Results: We performed 88 GIST resection cases. 19 (22%) cases were open, 61(69%) cases were laparoscopic and 8 (9%) cases were robotic in our Upper GI unit. The median age of the patients was 59 (range 48-82) years. The median LoS for Open was 9 (range 5-19) days, for laparoscopic it was 7 (range 5-12) days and for robotic 5 (range 2-9) days. Our data suggested significant difference in the LoS between the 3 groups. Tumour negative margins were accomplished in all case notes reviewed. The table attached shows the p-values.
Conclusion: Our data shows that with the advent of robotic technology, there is a significant reduction in the total LoS between the different techniques. In addition, our robotic surgery data suggests gastric GIST can be removed successfully from challenging anatomical locations avoiding radical excision such as gastrectomy. This may help reduce the need for HDU admission and improves functional outcome.
Aim: Our unit has been involved in removing Gastrointestinal stromal tumours (GISTs) for over 10 years. Recent technological advances and the inception of Robotic surgery has allowed us to achieve difficult local excisions successfully which would otherwise prove challenging.
With the development of robotic surgery, the DaVinci robot has allowed the surgeon to perform precise wedge resection with high definition 3D visualisation and instruments with endowrist technology.
This study was to see the difference in Length of Stay (LoS) comparing the three different techniques which includes Open vs Laparoscopic vs Robotic.
Methods: We looked at case notes retrospectively of all the gastric GISTs excised from 2011-2021. The database comprised of open, laparoscopic and robotic cases amongst 5 surgeons. Where case notes were unavailable, those were removed from data collection. LoS of the complete hospital admission was observed between the different techniques, open vs laparoscopic vs robotic. This was statistically assessed using Mann-Whitney U test on SPSS v22.
Results: We performed 88 GIST resection cases. 19 (22%) cases were open, 61(69%) cases were laparoscopic and 8 (9%) cases were robotic in our Upper GI unit. The median age of the patients was 59 (range 48-82) years. The median LoS for Open was 9 (range 5-19) days, for laparoscopic it was 7 (range 5-12) days and for robotic 5 (range 2-9) days. Our data suggested significant difference in the LoS between the 3 groups. Tumour negative margins were accomplished in all case notes reviewed. The table attached shows the p-values.
Conclusion: Our data shows that with the advent of robotic technology, there is a significant reduction in the total LoS between the different techniques. In addition, our robotic surgery data suggests gastric GIST can be removed successfully from challenging anatomical locations avoiding radical excision such as gastrectomy. This may help reduce the need for HDU admission and improves functional outcome.
Methods: We looked at case notes retrospectively of all the gastric GISTs excised from 2011-2021. The database comprised of open, laparoscopic and robotic cases amongst 5 surgeons. Where case notes were unavailable, those were removed from data collection. LoS of the complete hospital admission was observed between the different techniques, open vs laparoscopic vs robotic. This was statistically assessed using Mann-Whitney U test on SPSS v22.
Results: We performed 88 GIST resection cases. 19 (22%) cases were open, 61(69%) cases were laparoscopic and 8 (9%) cases were robotic in our Upper GI unit. The median age of the patients was 59 (range 48-82) years. The median LoS for Open was 9 (range 5-19) days, for laparoscopic it was 7 (range 5-12) days and for robotic 5 (range 2-9) days. Our data suggested significant difference in the LoS between the 3 groups. Tumour negative margins were accomplished in all case notes reviewed. The table attached shows the p-values.
Conclusion: Our data shows that with the advent of robotic technology, there is a significant reduction in the total LoS between the different techniques. In addition, our robotic surgery data suggests gastric GIST can be removed successfully from challenging anatomical locations avoiding radical excision such as gastrectomy. This may help reduce the need for HDU admission and improves functional outcome.
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