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Abstract：
BACKGROUND: The primary duodenal gastrointestinal stromal tumor (GIST) is a rare type of gastrointestinal tract tumor. Limited resection (LR) has been increasingly performed for duodenal GIST. However, only a few studies reported minimally invasive limited resection (MI-LR) for primary duodenal GIST.
METHODS: The clinical data of 33 patients with primary duodenal GIST from December 2014 to February 2024 were retrospectively analyzed including 23 who received MI-LR and 10 who received laparoscopic or robotic pancreaticoduodenectomy (LPD/RPD).
RESULTS: A total of 33 patients with primary duodenal GIST were enrolled and retrospectively reviewed. Patients received MI-LR exhibited less OT (280 vs. 388.5min, P=0.004), EBL (100 vs. 450ml, P<0.001), and lower morbidity of postoperative complications (52.2% vs. 100%, P=0.013) than LPD/RPD. Patients received LPD/RPD burdened more aggressive tumors with larger size (P=0.047), higher classification (P<0.001), and more mitotic count/50 HPF(P=0.005) compared with patients received MI-LR. The oncological outcomes were similar in MI-LR group and LPD/RPD group. All the patients underwent MI-LR with no conversion, including 12 cases of LLR and 11 cases of RLR. All of the clinicopathological data of the patients were similar in both groups. The median OT was 280(210-480) min and 257(180-450) min, and the median EBL was 100(20-1000) mL and 100(20-200) mL in the LLR and the RLR group separately. The postoperative complications mainly included DGE (LLR 4 cases, 33.4% and RLR 4 cases, 36.4%), intestinal fistula (LLR 2 cases, 16.7%, and RLR 0 case), gastrointestinal hemorrhage (LLR 0 case and RLR 1 case, 9.1%), and intra-abdominal infection (LLR 3 cases, 25.0% and RLR 1 case, 9.1%). The median postoperative length of hospitalization was 19.5(7-46) days in the LLR group and 19(9-38) days in the RLR group. No anastomotic stenosis, local recurrence or distant metastasis was observed during the follow-up period in the two groups.
CONCLUSIONS: Minimally invasive limited resection is an optional treatment for primary duodenal GIST with satisfactory short-term and long-term oncological outcomes.
METHODS: The clinical data of 33 patients with primary duodenal GIST from December 2014 to February 2024 were retrospectively analyzed including 23 who received MI-LR and 10 who received laparoscopic or robotic pancreaticoduodenectomy (LPD/RPD).
RESULTS: A total of 33 patients with primary duodenal GIST were enrolled and retrospectively reviewed. Patients received MI-LR exhibited less OT (280 vs. 388.5min, P=0.004), EBL (100 vs. 450ml, P<0.001), and lower morbidity of postoperative complications (52.2% vs. 100%, P=0.013) than LPD/RPD. Patients received LPD/RPD burdened more aggressive tumors with larger size (P=0.047), higher classification (P<0.001), and more mitotic count/50 HPF(P=0.005) compared with patients received MI-LR. The oncological outcomes were similar in MI-LR group and LPD/RPD group. All the patients underwent MI-LR with no conversion, including 12 cases of LLR and 11 cases of RLR. All of the clinicopathological data of the patients were similar in both groups. The median OT was 280(210-480) min and 257(180-450) min, and the median EBL was 100(20-1000) mL and 100(20-200) mL in the LLR and the RLR group separately. The postoperative complications mainly included DGE (LLR 4 cases, 33.4% and RLR 4 cases, 36.4%), intestinal fistula (LLR 2 cases, 16.7%, and RLR 0 case), gastrointestinal hemorrhage (LLR 0 case and RLR 1 case, 9.1%), and intra-abdominal infection (LLR 3 cases, 25.0% and RLR 1 case, 9.1%). The median postoperative length of hospitalization was 19.5(7-46) days in the LLR group and 19(9-38) days in the RLR group. No anastomotic stenosis, local recurrence or distant metastasis was observed during the follow-up period in the two groups.
CONCLUSIONS: Minimally invasive limited resection is an optional treatment for primary duodenal GIST with satisfactory short-term and long-term oncological outcomes.
摘要：
背景：原发性十二指肠胃肠道间质瘤（GIST）是一种罕见的胃肠道肿瘤。十二指肠GIST的有限切除术（LR）越来越多。然而,只有少数研究报道了原发性十二指肠GIST的微创有限切除术(MI-LR).
方法：回顾性分析2014年12月至2024年2月收治的33例原发性十二指肠GIST患者的临床资料，其中23例接受MI-LR，10例接受腹腔镜或机器人胰十二指肠切除术（LPD/RPD）。
结果：共纳入33例原发性十二指肠GIST患者并进行回顾性分析。接受MI-LR的患者表现出更少的OT（280vs.388.5min,P=0.004),EBL（100vs.450ml,P<0.001)，术后并发症的发病率较低(52.2%vs.100%,P=0.013)比LPD/RPD。患者接受LPD/RPD负担更大的肿瘤侵袭性更大（P=0.047），分类较高(P<0.001)，与接受MI-LR的患者相比，有丝分裂计数/50HPF更多（P=0.005）。MI-LR组和LPD/RPD组的肿瘤学结果相似。所有患者均行MI-LR，无转换，其中LLR12例,RLR11例。两组患者的所有临床病理资料相似。中位OT为280(210-480)min和257(180-450)min，LLR和RLR组的EBL中位数分别为100(20-1000)mL和100(20-200)mL.术后并发症主要包括DGE(LLR4例,33.4%和RLR4例，36.4%），肠瘘(LLR2例，16.7%,和RLR0情况)，消化道出血（LLR0例，RLR1例，9.1%)，和腹腔内感染(LLR3例，25.0%和RLR1例，9.1%）。LLR组的中位术后住院时间为19.5（7-46）天，RLR组为19（9-38）天。无吻合口狭窄,两组随访期间均有局部复发或远处转移。
结论：微创有限切除术是原发性十二指肠GIST的可选治疗方法，具有令人满意的短期和长期肿瘤结局。
方法：回顾性分析2014年12月至2024年2月收治的33例原发性十二指肠GIST患者的临床资料，其中23例接受MI-LR，10例接受腹腔镜或机器人胰十二指肠切除术（LPD/RPD）。
结果：共纳入33例原发性十二指肠GIST患者并进行回顾性分析。接受MI-LR的患者表现出更少的OT（280vs.388.5min,P=0.004),EBL（100vs.450ml,P<0.001)，术后并发症的发病率较低(52.2%vs.100%,P=0.013)比LPD/RPD。患者接受LPD/RPD负担更大的肿瘤侵袭性更大（P=0.047），分类较高(P<0.001)，与接受MI-LR的患者相比，有丝分裂计数/50HPF更多（P=0.005）。MI-LR组和LPD/RPD组的肿瘤学结果相似。所有患者均行MI-LR，无转换，其中LLR12例,RLR11例。两组患者的所有临床病理资料相似。中位OT为280(210-480)min和257(180-450)min，LLR和RLR组的EBL中位数分别为100(20-1000)mL和100(20-200)mL.术后并发症主要包括DGE(LLR4例,33.4%和RLR4例，36.4%），肠瘘(LLR2例，16.7%,和RLR0情况)，消化道出血（LLR0例，RLR1例，9.1%)，和腹腔内感染(LLR3例，25.0%和RLR1例，9.1%）。LLR组的中位术后住院时间为19.5（7-46）天，RLR组为19（9-38）天。无吻合口狭窄,两组随访期间均有局部复发或远处转移。
结论：微创有限切除术是原发性十二指肠GIST的可选治疗方法，具有令人满意的短期和长期肿瘤结局。
