Laparoendoscopic Transgastric Resection of a Submucosal Mass at the Gastroesophageal Junction

Ghushe, Neil; Dulai, Parambir S.; Trus, Thadeus L.

doi:10.1007/s11605-012-2038-8

Cited by 9 publications

(3 citation statements)

References 2 publications

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“…Even still, there were no conversions to open surgery seen in this series. Comparable results were observed in previous studies published by Hiki et al, Qui et al, and Tsujimoto et al [1, 3, 12]. …”

Section: Discussionsupporting

confidence: 87%

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Laparo-endoscopic transgastric resection of gastric submucosal tumors

et al. 2014

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Background Laparoscopic and endoluminal surgical techniques have evolved and allowed improvements in the methods for treating benign and malignant gastrointestinal diseases. To date, only case reports have been reported on the application of a laparo-endoscopic approach for resecting gastric submucosal tumors (SMT). In this study, we aimed to evaluate the efficacy, safety, and oncologic outcomes of a laparo-endoscopic transgastric approach to resect tumors that would traditionally require either a laparoscopic or open surgical approach. Herein, we present the largest single institution series utilizing this technique for the resection of gastric SMT in North America. Methods We performed a retrospective review of a prospectively collected patient database. Patients who presented for evaluation of gastric SMT were offered this surgical procedure and informed consents were obtained for participation in the study. Results Fourteen patients were included in this study between August/2010 and January/2013. Eight (8) patients (57.1 %) were female and the median age was 56 years (range 29–78). Of the 14 cases, 8 patients (57.1 %) underwent laparo-endoscopic resection of SMTs with transgastric extraction, 5 patients (35.7 %) had conversions to traditional laparoscopic surgery, and 1 patient (7.2 %) was abandoned intraoperatively. The median operative time for this cohort was 80 min (range 35–167). Ten patients (71.4 %) had GISTs, 3 (21.4 %) had leiomyomas, and 1 (7.1 %) had schwannoma. There were no intraoperative complications. Two patients had postoperative staple line bleeding that required repeat endoscopy. The median hospital stay was 1 day (range 1–6) and there were no postoperative mortalities. At 12-month follow-up visit, only one GIST patient (10 %) had tumor recurrence. Conclusion Our experience suggests that this surgical approach is safe and efficient in the resection of gastric SMT with transgastric extraction. This study found no intraoperative complications and optimal oncologic outcomes during the follow-up period. Minimally invasive surgical approaches are emerging as a valid and potentially better approach for resecting malignancies; however, continued investigation is underway to further validate this data.

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Section: Discussionsupporting

confidence: 87%

“…Specifically, the role for laparo-endoscopic procedures in cancer surgery is clear and limited to specific circumstances in which the tumor resection does not include lymph node dissection, involves upper GI tract tumors, no anastomoses are required, or when the location is remote and otherwise difficult to access [11, 12]. …”

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confidence: 99%

Laparo-endoscopic transgastric resection of gastric submucosal tumors

et al. 2014

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“…Tumor removal is performed using submucosal dissection. In later series, a similar approach is described for the resection of submucosal tumors, including GISTs [18][19][20]. In one of the larger case series, Kanehira et al present the short-and long-term result after removal of GISTs at the EGJ using intra-gastric surgery [21].…”

Section: Discussionmentioning

confidence: 99%

Minimally invasive technique for gastric GIST at challenging locations: single incision surgical gastroscopy

et al. 2023

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Organ sparing resection of gastrointestinal stromal tumors (GISTs) located in the proximal stomach or esophagogastric junction can be challenging, resulting in proximal or total gastrectomy to facilitate a radical resection without tumor spill. We developed and evaluated a single incision surgical gastroscopy (SISG) procedure to provide a technically feasible alternative for the removal of gastric GISTs at these challenging locations. We developed an endoluminal resection of gastric GISTs through a small single abdominal incision and longitudinal ventral gastrotomy. Patients with a proximal tumor location, in whom a wedge resection was deemed challenging on pre-operative investigation were included in the current series. Safety, short-term oncological and surgical outcome were evaluated. We performed SISG in six consecutive patients with histopathological proven or suspected gastric GIST. In all patients, the procedure was performed successfully with no tumor rupture. The mean operative time was 61 min and there were no significant complications. Pathological examination showed a microscopically radical resection in all patients. Single incision surgical gastroscopy is a feasible technique with excellent short-term oncological and surgical outcomes. This technique serves as a good alternative for complicated resections for gastric GISTs at challenging locations.

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Minimally Invasive Intragastric Surgery

Mutter

Nedelcu

2014

Minimally Invasive Foregut Surgery for Malignancy

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Laparoendoscopic Transgastric Resection of a Submucosal Mass at the Gastroesophageal Junction

Cited by 9 publications

References 2 publications

Laparo-endoscopic transgastric resection of gastric submucosal tumors

Laparo-endoscopic transgastric resection of gastric submucosal tumors

Minimally invasive technique for gastric GIST at challenging locations: single incision surgical gastroscopy

Minimally Invasive Intragastric Surgery

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