Study on SILS vs. CLS for Gastric GISTs

In a recent study, Ji Won Seo and team found the outcomes of single-incision laparoscopic surgery (SILS) better than conventional laparoscopic surgery (CLS) for treating gastric gastrointestinal stromal tumors (GISTs). The findings of the study were published in BMC Surgery.

Between November 2020 and April 2022, a group of 15 consecutive patients with gastric GIST underwent single-incision gastric wedge resection, forming the SILS group. This group's early perioperative outcomes were then meticulously analyzed and compared with a corresponding group of 15 patients who had undergone conventional laparoscopic surgery (CLS). The selection criteria for the surgical approach were consistent with those used for traditional laparoscopic procedures for gastric GIST.

Key Findings

• The estimated blood loss and intraoperative blood transfusion were comparable between the SILS and CLS groups, signifying similar surgical efficacy and safety.
• Notably, the SILS group experienced no intraoperative complications or instances requiring a shift to multiple-port or open surgery.
• The choice of surgical technique seemed to be influenced by tumor location. Tumors located proximally were more frequently treated with CLS, while those situated in the greater curvature tended to be addressed through SILS.
• A marked difference emerged in terms of incision length and postoperative recovery. The mean incision length in the SILS group was considerably shorter than that in the CLS group, translating to potential benefits in terms of postoperative pain and cosmetic outcomes.
• The SILS group also reported lower postoperative analgesic doses and a shorter duration of analgesic usage compared to the CLS group, further highlighting the potential advantages of the single-incision approach.

Crucially, the study showed that SILS could be considered a safe, feasible, and effective alternative to conventional laparoscopic surgery for treating gastric GISTs. The comparable rates of postoperative complications between the two techniques emphasize SILS's viability. Moreover, the study concluded that the choice between SILS and CLS need not be influenced by the type or location of the tumor, adding to the versatility of the single-incision approach.

Reference

Seo, J. W., Park, K. B., Chin, H. M., & Jun, K.-H. (2023). Is single incision laparoscopic surgery (SILS) for gastric gastrointestinal stromal tumor (GIST) dependent on the location of the tumor? In BMC Surgery. Springer Science and Business Media LLC. https://doi.org/10.1186/s12893-023-02141-0