Combined endolaparoscopic intragastric excision for gastric neoplasms

J Laparoendosc Adv Surg Tech A. 2009 Dec;19(6):765-70. doi: 10.1089/lap.2009.0067.

Abstract

Background: The aim of this study was to describe our technique of combined endolaparoscopic approach to the management of intraluminal gastric neoplasms and to review the clinical outcome.

Methods: Between February 2006 and January 2008, a total of 12 patients with gastric neoplasm < or =4 cm with a mainly intraluminal component received the combined endolaparoscopic intragastric excision and were prospectively analyzed. All lesions were localized endoscopically and then treated by using a combined endoscopic submucosal dissection and laparoscopic intragastric technique.

Results: Eight of 12 lesions were gastrointestinal stromal tumours. The remaining lesions were adenomatous polyp with focal intramucosal adenocarcinoma, leiomyoma, and pancreatic heterotopia. All except 1 case was successfully treated with this technique (91.6%). There were no mortalities, and there was only 1 case of reactionary hemorrhage from the port site requiring a reoperation. The median operating time was 120 minutes, with a median blood loss of 35 mL. Length of hospital stay ranged from 3 to 12 days. There were no recurrences during the follow-up period.

Conclusions: This combined endolaparoscopic intragastric excision technique is a truly minimally invasive alternative for selected gastric neoplasm. It is safe and feasible with a satisfactory short-term outcome.

MeSH terms

  • Adenoma / pathology
  • Adenoma / surgery
  • Aged
  • Aged, 80 and over
  • Carcinoma / pathology
  • Carcinoma / surgery
  • Cohort Studies
  • Female
  • Gastrectomy / methods*
  • Gastrointestinal Stromal Tumors / pathology
  • Gastrointestinal Stromal Tumors / surgery*
  • Gastroscopy / methods*
  • Humans
  • Laparoscopy / methods*
  • Leiomyoma / pathology
  • Leiomyoma / surgery
  • Male
  • Middle Aged
  • Retrospective Studies
  • Stomach Neoplasms / pathology*
  • Stomach Neoplasms / surgery*
  • Treatment Outcome