Published online Aug 15, 2021. doi: 10.4251/wjgo.v13.i8.959
Peer-review started: June 9, 2021
First decision: June 15, 2021
Revised: June 18, 2021
Accepted: July 5, 2021
Article in press: July 5, 2021
Published online: August 15, 2021
Duodenal gastrointestinal stromal tumors (DGISTs) rarely break the tumor capsule and lymph node metastases seldom occur. However, the duodenum is located near the pancreas and biliary tract. Traditional Whipple surgery results in severe injury; thus, it is necessary to preserve as much normal tissue as possible.
The present study attempted to identify the factors influencing the surgical treatment of DGISTs and to determine the best surgical procedure.
This study aimed to investigate the factors influencing DGIST surgery and provide advice regarding the best surgical technique.
The clinicopathological data of patients with DGISTs who underwent surgery from January 1999 to January 2021 were analyzed. The Student t test or Mann-Whitney U-test and χ2 test or Fisher’s exact test were used to identify differences between the two groups of patients treated with different surgical techniques. Logistic regression analysis was carried out to assess the relevant factors influencing the choice of surgical procedure.
There were no differences in age, mitotic figures and complications between these two groups, while the tumor size, tumor location, risk grade, postoperative hospital time, and abdominal drainage time showed statistically significant differences. Using univariate logistic analysis, if the tumor was ≥ 5.0 cm in size, located in the descending part of the duodenum or the risk grade was medium or high, Whipple surgery was performed.
If the primary tumor was in the descending part of the duodenum, was ≥ 5.0 cm in size and the risk grade was medium or high, Whipple surgery was performed.
Although we investigated the factors influencing the surgical treatment of duodenal gastrointestinal stromal tumors and assessed the best surgical procedure for these patients, a prospective study should be performed to confirm these findings.