Transvaginal Specimen Extraction After Laparoscopic Gastrectomy for Tumors

Abstract

Aim:The aim was to evaluate the feasibility of transvaginal specimen extraction after laparoscopic gastrectomy for tumors.Method: Inclusion criteria were females not planning to deliver a child and an accessible vaginal entry. Exclusion criteria were benign gastric pathologies and emergency cases.Results: There were 24 females with a mean age of 54.5 ± 12.0. Subtotal, total, central, and vertical gastrectomies were implemented in 17, 4, 2, and 1 patients, respectively. There was no conversion to open or conventional laparoscopic surgery. Specimens were removed from the vagina in all cases successfully. Histopathologies were adenocarcinoma in 20, gastrointestinal stromal in 3, neuroendocrine tumors in 2 and high-grade dysplasia in the rest. Mean blood loss and duration of surgery were 122.5 ± 163.4 (range: 10 to 800) ml. and 287.7 ± 95.9 (range: 120 to 440) minutes, respectively. No patient required intraoperative blood transfusions. The median length of hospital stay was 7 days (range: 3 to 22). The mean tumor size was 7.8 ± 6.5 (range: 0.5 to 24) cm. Fourteen of 24 cases were advanced gastric cancers. Mean dissected lymph node numbers in the patients with radical gastrectomy was 35.3 ± 12.9 (range: 18 to 62). There were no early or late complications related to the specimen extraction and no wound-related problems were observed.Conclusions: In the selected cases, transvaginal specimen extraction was feasible after laparoscopic gastric resections in patients with stomach tumors. As far as we know, this was the largest study on the transvaginal extraction of gastric tumors.