Effect of Minimally Invasive Surgical Training Center on Laparoscopic Surgery: Observation from Preliminary Results for Primary Stomach GastroIntestinal Stromal Tumor in a Health Care System
Authors
Yueh-Tsung Lee, Sheng-Lei Yan, Der-Aur Chou, Shin-Wei Huang, Chien-Hua Lin, Yi-Ju Wu, Hsiang-Jen Hou, Min-Chang Hung, Jing-Jim Ou, Chia-Ying Li, Jen-Chang Guo<, Yih-Shyong Lai, Chien-Long Kuo, Hurng-Sheng Wu and Min-Ho Huang1,4,6 Department of Surgery; Department of Internal Medicine; 3Department of Pathology, Chang-Bing Show Chwan Memorial Hospital, Lu-Gang, Chang-Hua, Taiwan; 4Department of Surgery; 5Department of Pathology, Chang-Hua Show Chwan Memorial Hospital, Chang-Hua, Taiwan; 6Asian IRCAD, The Research Institute against Cancer of the Digestive Tract, Asian Institute of TeleSurgery (AITS) in Taiwan
Gastrointestinal stromal tumors (GISTs), are different from other mesenchymal tumors by immunohistochemistric biomarkers and are often encountered in the alimentary tract and less commonly originating from omentum, mesentery and peritoneum. They usually present as subepithelial tumors in the gastrointestinal tract or intraabdominal masses with malignant potential. The tumors might cause symptoms such as pain, intraluminal or extraluminal GI tract bleeding and obstruction but might also present as incidental findings. Gastroscopy, Ultrasonography and CT scan are employed for preoperative evaluation. The surgical principles are to excise the tumor with safe margin microscopically. Minimally invasive procedures are revolutionary innovation in surgery. Asian Institute of TeleSurgery training center is established in mid Taiwan in 2008 with the cooperation between Show Chwan Health Care System and European Institute of TeleSurgery in Strasbourg, France. We retrospectively reviewed 24 primary stomach GISTs operated at our institution in the past four years. The patients were divided into laparoscopy group (18 patients) and laparotomy group (6 patients) depending on the main surgical methods. The patients’ age, gender, hospital stay, operative time, blood loss, tumor size and complication rate were used for stastical analysis. There were significant differences in tumor size and blood loss between the two groups with a p value of less than 0.05. In the past 4 years, 75% of primary gastric GISTs in our hospital were managed by laparoscopic surgery. Our experience showed that laparoscopic surgery is feasible for primary stomach GISTs in selective cases.
