{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,29]],"date-time":"2026-09-29T14:23:07Z","timestamp":1790691787180,"version":"4.1.0"},"reference-count":29,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2024,5,23]],"date-time":"2024-05-23T00:00:00Z","timestamp":1716422400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Surg."],"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Gastric gastrointestinal stromal tumors in challenging anatomical locations are difficult to remove.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This study retrospectively analyzed the clinical data of 12 patients with gastric GISTs in challenging anatomical locations who underwent robot-assisted laparoscopic combined with endoscopic partial gastrectomy (RALE-PG) and manual suturing of the gastric wall.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      This study included 12 patients with a mean age of 56.8\u2009\u00b1\u20099.8 years and a mean BMI of 23.9\u2009\u00b1\u20091.9\u2005kg\/m\n                      <jats:sup>2<\/jats:sup>\n                      . Tumors were located in the GEJ (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u20093), lesser curvature (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u20093), posterior gastric wall (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u20093) and antrum (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u20093). The cardia and pylorus were successfully preserved in all patients regardless of the tumor location. The mean tumor size was 4.5\u2009\u00b1\u20091.4\u2005cm. The mitotic-count\/50\u2005mm\n                      <jats:sup>2<\/jats:sup>\n                      was less than 5 in all patients (100%). There was no intraoperative tumor rupture (0%) and no conversion to open surgery (0%). The median operation time was 122 (97\u2013240) min, and the median blood loss volume was 10 (5\u201330) ml. The median postoperative VAS score was 2 (2\u20134). The median time to first flatus was 2 (2\u20133) days. The median time to first fluid intake was 2 (2\u20133) days. The median time to first ambulation after the operation was 3 (2\u20134) days. No cases of anastomotic stenosis or leakage were found. The median time to drain removal for 6 patients was 5 (4\u20137) days. The median time to nasogastric tube removal for all patients was 2 (1\u20135) days. The median postoperative hospital stay was 5 (4\u20138) days. One patient (female\/41 year) developed moderate anemia (Clavien-Dindo grade II complication). There was no unplanned readmission within 30 days after the operation. The median distance from the tumor to the resection margin was 1 (1\u20132) cm. R0 resection was achieved in all patients. The median follow-up period was 19 (10\u201325) months, and all patients survived with no recurrence or metastasis.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>RALE-PG is a safe, feasible and advantageous technique for treating GISTs in challenging anatomical locations. It can be used to accurately remove the tumor while preserving gastric function to the greatest extent, but long-term oncologic outcomes need to be evaluated in a study with a larger sample size and longer follow-up period.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fsurg.2024.1391387","type":"journal-article","created":{"date-parts":[[2024,5,23]],"date-time":"2024-05-23T00:44:55Z","timestamp":1716425095000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":4,"title":["Robot-assisted laparoscopic combined with endoscopic partial gastrectomy (RALE-PG) for the treatment of gastric gastrointestinal stromal tumors in challenging anatomical locations: single-center 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