Laparoscopic and endoscopic cooperative surgery for gastrointestinal tumor

Niimi, Keiko; Ishibashi, Rei; Mitsui, Takashi; Aikou, Susumu; Kodashima, Shinya; Yamashita, Hiroharu; Yamamichi, Nobutake; Hirata, Yoshihiro; Fujishiro, Mitsuhiro; Seto, Yasuyuki; Koike, Kazuhiko

doi:10.21037/atm.2017.03.35

Cited by 23 publications

(13 citation statements)

References 34 publications

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“…In order to overcome limits of MI techniques like laparoscopic and endoscopic surgery, some authors described laparoscopic and endoscopic cooperative surgery (LECS) [66]. The drawbacks of LECS are considered the approach to only small lesions and the potential risk of gastric tumor cells spilling into the abdomen because during the procedures the gastric wall may be opened [67,68]. Some modifications to LECS were described, like inverted LECS [69], non-exposure technique (CLEAN-NET) [70], endoscopic full-thickness resection [71], and closed-LECS [72,73].…”

Section: Discussionmentioning

confidence: 99%

Minimally Invasive Approach to Gastric GISTs: Analysis of a Multicenter Robotic and Laparoscopic Experience with Literature Review

Ceccarelli

Costa

Rosa

et al. 2021

Cancers

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Background: Gastrointestinal stromal tumors (GISTs) are most frequently located in the stomach. In the setting of a multidisciplinary approach, surgery represents the best therapeutic option, consisting mainly in a wedge gastric resection. (1) Materials and methods: Between January 2010 to September 2020, 105 patients with a primary gastrointestinal stromal tumor (GISTs) located in the stomach, underwent surgery at three surgical units. (2) Results: A multi-institutional analysis of minimally invasive series including 81 cases (36 laparoscopic and 45 robotic) from 3 referral centers was performed. Males were 35 (43.2%), the average age was 66.64 years old. ASA score > 3 was 6 (13.3%) in the RS and 4 (11.1%) in the LS and the average tumor size was 4.4 cm. Most of the procedures were wedge resections (N = 76; 93.8%) and the main operative time was 151 min in the RS and 97 min in the LS. Conversion was necessary in five cases (6.2%). (3) Conclusions: Minimal invasive approaches for gastric GISTs performed in selected patients and experienced centers are safe. A robotic approach represents a useful option, especially for GISTs that are more than 5 cm, even located in unfavorable places.

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Section: Discussionmentioning

confidence: 99%

Minimally Invasive Approach to Gastric GISTs: Analysis of a Multicenter Robotic and Laparoscopic Experience with Literature Review

Ceccarelli

Costa

Rosa

et al. 2021

Cancers

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“…However, a complete resection with a negative surgical margin is the curative treatment for GS, as with GIST or other SMTs [3-5, 7, 9]. Recently, laparoscopic and endoscopic cooperative surgery (LECS) has been increasingly applied for gastric SMTs [11]. The conventional LECS procedure runs the potential risk of gastric content or tumor cell spilling into the abdominal cavity.…”

Section: Discussionmentioning

confidence: 99%

A Rare Case of Gastric Schwannoma: A Case Report and Literature Review

et al. 2020

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In general, schwannoma is a benign and slow-glowing neoplasm that rarely occurs in the gastrointestinal tract as a submucosal tumor (SMT), with the most common site being the stomach. As gastric schwannoma (GS) is a rare tumor, there is limited data in the literature about its clinical features. The diagnosis of schwannoma can only be made by pathological examination with positive staining for S-100 protein. It is necessary to obtain an accurate diagnosis to introduce optimal treatment options preoperatively. However, a precise diagnosis of GS is difficult, even with modern imaging techniques. On the other hand, a complete resection with a negative surgical margin (R0) of GS is considered the best treatment, with an excellent prognosis. We present a case of a 66-year-old female patient who underwent laparoscopic-assisted wedge gastrectomy for gastric SMT, pathologically diagnosed as GS, with positive staining for S-100 protein and negative for c-kit and CD34. At 12-month follow-up after surgery, there was no recurrence or metastasis of GS. Our treatment is appropriate and effective in case of GS exceeding 50 mm.

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“…Laparoscopic and endoscopic cooperative surgery (LECS), which was first applied to gastric mesenchymoma resection, can be used to avoid the deficiency of single application of endoscopic surgical techniques and laparoscopic surgical technique [12]. Nevertheless, the conventional LECS procedure has the potential risk of gastric contents or tumor cells spilling into the abdominal cavity since the gastric wall has to be opened during the procedure [13,14]. To avoid this problem, some modified LECS procedures have been investigated, such as inverted LECS [15], a combination of laparoscopic and endoscopic approaches to neoplasia with a nonexposure technique (CLEAN-NET) [16], nonexposed endoscopic wall-inversion surgery (NEWS) [17,18], endoscopic full-thickness resection [19], and nonexposure laparoscopic and endoscopic cooperative surgery (closed-LECS) [20].…”

Section: Discussionmentioning

confidence: 99%

Laparoscopic and Endoscopic Cooperative Dissection for Small Gastric Gastrointestinal Stromal Tumor without Causing Injury to the Mucosa

Cao¹,

Zheng²,

Wang³

et al. 2019

Gastroenterology Research and Practice

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Objective. To investigate the feasibility of laparoscopic and endoscopic cooperative dissection (LECD) for small gastric gastrointestinal stromal tumors (GISTs) without causing injury to the mucosa, compared with ESD surgery which is widely used now. Methods. A total of 25 patients with small gastric GISTs who underwent LECD and 20 patients with small gastric GISTs who underwent ESD between October 2014 and June 2016 were included in this study. All patients underwent curative resection for pathologically diagnosed small gastric GISTs. Patients' clinical data were retrospectively analyzed. Results. In LECD group, the operation was successfully performed in all patients. However, in the ESD group, three patients were transferred to laparoscopic surgery due to intraoperative massive bleeding or intraoperative perforation. No additional targeted chemotherapy drugs for interstitial tumors were prescribed in two groups. There was no difference in the complete tumor capsule rate (100% vs. 90%, p = 0:11), operation time (80:76 ± 13:86 ml vs. 84:05 ± 15:33 ml, p = 0:45), major intraoperative bleeding (0 vs. 5%, p = 0:26), postoperative bleeding (0 vs. 10%, p = 0:11), and postoperative infection (0 vs. 10%, p = 0:11) between the two groups. Compared to ESD (endoscopic submucosal dissection), LECS patients had shorter postoperative indwelling gastric tube (1:04 ± 0:98 d vs. 2:85 ± 0:24 d, p < 0:01), earlier postoperative eating (1:96 ± 0:98 d vs. 3:50 ± 1:15 d, p < 0:01), shorter average postoperative hospital stay (3:44 ± 1:00 d vs. 7:85 ± 1:18 d, p < 0:01), smaller perforation rate (0 vs. 25%, p < 0.05), and fewer surgical supplies. No recurrence or metastasis cases were found between the two groups during the follow-up period, and there were no cases of death due to gastric GISTs. Conclusion. LECD is a novel surgery for small gastric gastrointestinal stromal tumors that leads to satisfactory short-term outcomes and meets the idea of minimally invasive surgery and rapid recovery; compared with ESD, LECD surgery has some advantages in clinical practice. However, further follow-up is needed to confirm.

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Laparoscopic and endoscopic cooperative surgery for gastrointestinal tumor

Cited by 23 publications

References 34 publications

Minimally Invasive Approach to Gastric GISTs: Analysis of a Multicenter Robotic and Laparoscopic Experience with Literature Review

Minimally Invasive Approach to Gastric GISTs: Analysis of a Multicenter Robotic and Laparoscopic Experience with Literature Review

A Rare Case of Gastric Schwannoma: A Case Report and Literature Review

Laparoscopic and Endoscopic Cooperative Dissection for Small Gastric Gastrointestinal Stromal Tumor without Causing Injury to the Mucosa

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