Short-term and long-term outcomes after robotic radical surgery for rectal gastrointestinal stromal tumor

BMC Surg. 2024 May 9;24(1):141. doi: 10.1186/s12893-024-02434-y.

Abstract

Background: The optimal approach for ensuring both complete resection and preservation of anal function in rectal gastrointestinal stromal tumor (GIST) remains unknown. The aim of this study was to clarify short-term and long-term outcomes after robotic radical surgery for rectal GIST.

Methods: A total of 13 patients who underwent robotic radical surgery for rectal GIST between December 2011 and April 2022 were included. All robotic procedures were performed using a systematic approach. A supplemental video of robotic radical surgery for rectal GIST is attached. The short-term outcome was the incidence of postoperative complications during the first 30 days after surgery. Surgical outcomes were retrieved from a prospective database. Long-term outcomes, including overall survival and recurrence-free survival, were determined in all patients.

Results: Median distance from the tumor to the anal verge was 4.0 cm. Surgical margins were negative in all patients. Two patients underwent neoadjuvant imatinib therapy. All patients underwent sphincter-preserving surgery. None underwent conversion to open or laparoscopic surgery. The incidence of postoperative Clavien-Dindo grade II and grade ≥ III complications was 7.7% and 0%, respectively. The median postoperative hospital stay was 7 days. Twelve patients (92.3%) underwent stoma closure within 5 months of the initial surgery. Median follow-up time was 76 months. The 5-year overall survival and recurrence-free survival rates were both 100%. None of the patients had recurrence.

Conclusion: Short-term and long-term outcomes after radical robotic surgery for rectal GIST were favorable. Robotic surgery might be a useful surgical approach for rectal GIST.

Keywords: Gastrointestinal stromal tumor (GIST); Robotic surgery; Sphincter preservation; rectal GIST.

MeSH terms

  • Adult
  • Aged
  • Female
  • Follow-Up Studies
  • Gastrointestinal Stromal Tumors* / surgery
  • Humans
  • Male
  • Middle Aged
  • Postoperative Complications* / epidemiology
  • Postoperative Complications* / etiology
  • Rectal Neoplasms* / surgery
  • Retrospective Studies
  • Robotic Surgical Procedures* / methods
  • Time Factors
  • Treatment Outcome