Gastrectomía laparoscópica en carcinoide gástrico

Abstract

Laparoscopic gastrectomy in gastric carcinoidIntroduction: Gastric carcinoid is a very low frequency tumor. A proportion of them require surgery to control the disease. The ideal surgical treatment is controversial. Aim: To describe the perioperative and follow-up course of patients with gastric carcinoid subjected to laparoscopic gastrectomy. Materials and Methods: Retrospective study of patients undergoing some type of laparoscopic gastrectomy for gastric carcinoid the last 10 years. We collected demographic background, preoperative evaluation, type of surgery, complications and follow-up. Results: During the study period were operated 7 patients, 5 were men. The average age was 54 years. In three patients the diagnosis was a finding, while the rest had abdominal pain associated with nonspecific symptoms. Four patients had a type I gastric carcinoid associated with chronic gastritis and hypergastrinemia, and the others had a type III gastric carcinoid. Six patients underwent laparoscopic total gastrectomy while in the remaining patient (type III) was subtotal. There were no postoperative complications. During follow-up one patient required a reoperation for mechanical ileus secondary to adhesions and one patient required endoscopic dilatation because esophagoyeyunostomy stenosis. At 32 months of median follow-up (1-52) no patient has relapsed. Conclusion: Laparoscopic gastrectomy is an alternative in the surgical treatment of patients with gastric carcinoid. It´s safe and represent adequate oncological results in the short and medium term.

Caso Clínico: Tumor Neuroendocrino Gástrico

“…En una revisión del registro físico de procedimientos quirúrgicos llevados a cabo desde enero de 2017 hasta marzo de 2018 en la unidad de cirugía oncológica, del Hospital de Especialidades José Carrasco Arteaga, de los 25 tumores de localización gástrica, sólo el presente caso ha tenido diagnóstico de tumor neuroendócrino, lo que confirma así, la baja incidencia de los neuroendocrinos gástricos [2,9]. En un estudio retrospectivo realizado en Chile en el periodo comprendido entre los años 2002 -2012 en el Departamento de Cirugía Digestiva, Pontificia Universidad Católica de Chile, se operaron 9 pacientes por neuroendocrino gástrico, el diagnóstico se llevó acabo por un hallazgo durante una endoscopia digestiva alta solicitada por otro motivo; como se observó en este paciente, que presentó sintomatología inespecífica y se solicitó endoscopia digestiva alta, para llegar al diagnóstico [10,13].…”

“…En los tumores neuroendócrinos tipo III, se podría considerar manejo laparoscópico pero no está del todo establecido hasta la actualidad, sin embargo, es una cirugía segura y de baja morbimortalidad, de resultados oncológicos adecuados en el seguimiento a corto y mediano plazo de este tipo de pacientes [9,10]…”