Application of Laparoscopic Techniques for Resection of Individual Gastric Submucosal Tumors

Abstract

Large gastric submucosal tumors should be excised to prevent ischemic mucosal ulceration of the overlying surface and central necrosis of the neoplasm, which may in turn lead to massive hemorrhage. Large tumors near the esophagocardiac junction or on the posterior wall are usually resected by an open procedure. We describe 2 cases of upper gastrointestinal tract bleeding owing to huge submucosal tumors in the posterior gastric high body treated by laparoscopic resection of the gastric tumors. These 2 patients recovered smoothly without major or minor complications. We emphasize that design of specific strategies for individual tumors is essential for the successful laparoscopic resection of tumors adjacent to the esophagocardiac junction and large tumors on the posterior wall.

Full-thickness endoscopic resection of nonintracavitary gastric stromal tumors: a novel approach

“…Currently, the conventional treatment of stromal tumors is primarily open surgery or laparoscopic excision [1][2][3][4][5][6][7][8][9][10]. Reports of both techniques, including, for example, en bloc removal of an extra-gastrointestinal stromal tumor (EGIST) of the greater omentum and laparoscopic intragastric approach for gastrointestinal stromal tumor (GIST) of the posterior gastric wall, show that conventional treatment can meet surgical challenges and achieve satisfactory outcomes [1,3].…”

Endoscopic dissection of large endogenous myogenic tumors in the esophagus and stomach is safe and feasible: A report of 42 cases

“…Serious bleeding occurred in five patients in our earlier reported series and successful hemostasis was achieved in each case by using the argon plasma coagulator and titanium clip under endoscopic guidance. The same technique was successfully applied for patients [2] who experienced bleeding in the present series. Even though the incidence of complications may be higher with endoscopic resection than with laparoscopic resection, we have shown that the types of complications that occur can be successfully managed by endoscopic and conservative treatment [16].…”

“…Even though endoscopic resection is generally thought to be suitable only for small tumors [2,3,14,18], we have shown that lesions >2 cm can be 2 20.95 ± 2.56 22.05 ± 3.21 0.143 Cost (Â10,000 dollars) 2 1.18 ± 0.31 2.57 ± 0.44 <0.001* Complication, n (%) 3 12 (28.6) 3 (13.6) 0.180…”

“…Currently, submucosal myogenic tumors, including leiomyoma and stromal tumors as described in this study, are mainly treated by conventional methods such as open surgery or laparoscopic excision [1][2][3][4][5][6][7][8].…”

Gastrointestinal stromal tumours at present: an approach to burning questions

“…In the last few years there has been increasing evidence of laparoscopic surgery as a safe and predictable means of adequate resection for these tumours [12,[62][63][64][65][66][67][68][69], with reported experience prevailing in gastric GISTs. Results have been uniformly good, showing that laparoscopic GIST resection is feasible and associated to acceptable morbidity and mortality and short postoperative stay.…”