92 | wetenschapsdag 2023 Sessie 3b: Chirurgie Voorbij de Scalpel x3 Auteurs S.J.C. van der Burg, R.F. Bleckman, S.N. Hakkesteegt, N. Steeghs, D.J. Grunhagen, B. van Etten, A.K.L. Reyners, J.J. Bonenkamp, H.H. Hartgrink, M.W.J.M. Wouters, W.J. van Houdt, Y.M. Schrage Abstract titel Improvement of textbook outcome of gastric gastrointestinal stromal tumor surgery in the first thirteen years of the Dutch GIST registry Background The Dutch gastrointestinal stromal tumor (GIST) consortium, comprising five GIST expert centers in the Netherlands, established the prospective Dutch GIST Registry (DGR) in 2009 to enhance the quality of GIST care and to facilitate research. This study aims to evaluate the changes in quality of surgical procedures and surgical outcomes after gastric GIST resections. Methods All patients who underwent a wedge resection or a partial gastrectomy for localized gastric GISTs recorded in the DGR between January 2009 and January 2022 were included. Metastasized patients were excluded. To evaluate the variation in quality over time, patients were segregated into four equal periods. GIST-specific textbook outcomes (TO) were used as composite measure for surgical outcomes. Results A total of 472 patients were included in the study. Patient and tumor characteristics were consistent over time, except for the median age (62 vs. 65 vs. 68 vs. 68, p = 0.002) at time of surgery and the proportion of minimal invasive surgery (MIS) per period (7% vs. 17% vs. 43% vs. 60%, p < 0.001). The proportion of achieved TO increased significantly over time (54% vs. 53% vs. 66% vs. 76%, p < 0.001). Predictors for TO were surgery performed in more recent years (OR 1.68 [CI 95% 1.28-2.23], p <0.001), lower age (OR 0.97 [CI 95% 0.95-0.99], p = 0.004), MIS (OR 0.97 [CI 95% 0.95-0.99], p = 0.004), and lower ASA scores (OR 0.65 [CI 95% 0.440.97], p = 0.035). Furthermore, a decrease was seen in the median duration of surgery in minutes (92 vs. 94 vs. 77 vs. 73, p=0.007) and the median length of hospital stay following surgery in days (6 vs. 6 vs. 5 vs. 4, p<0.001). Conclusion The quality and perioperative outcomes of gastric GIST surgery in the five Dutch expert centers have improved over time.
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