Laparoscopic intragastric stapled resection of gastric submucosal tumors located near the esophagogastric junction

Tagaya, Nobumi; Mikami, Hidetoshi; Kogure, Hiroaki; Kubota, Keiichi; Hosoya, Yoshinori; Nagai, Hideo

doi:10.1007/s004640080158

Cited by 87 publications

(81 citation statements)

References 19 publications

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“…Finally, two small series have suggested a role for a combined endoscopic and laparoscopic approach, using two or three intragastric trocars. This proved feasible for resection of GISTs of the oesophagogastric junction 42,43 . Still, it is a technically demanding procedure that requires advanced laparoscopic skills and instrumentation.…”

Section: Lesser Curvature and Gastro-oesophageal Junctionmentioning

confidence: 99%

Surgical management of gastrointestinal stromal tumours

Gervaz

Huber

Morel

2009

British Journal of Surgery

100

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Background: Over the past decade, gastrointestinal stromal tumours (GISTs) have served as a model for the application of tyrosine kinase inhibitors in the treatment of solid neoplasms. Operative and medical management of GISTs is rapidly evolving, but current guidelines appear restricted to basic non-organ-specific recommendations.Methods: A PubMed search was made of the English literature from 1998 to 2008 for references containing the terms 'gastrointestinal stromal tumours' and 'surgery'. This paper reviews the various operative strategies so far reported for GISTs within the digestive tract.Results: Many original procedures tailored to the specific characteristics of these rare sarcomas have been reported. GISTs exhibit distinct features, in particular an absence of metastases within locoregional lymph nodes. Operations requiring extended lymph node dissection, typically designed for adenocarcinomas, such as gastrectomy with extended lymph node dissection, Whipple's procedure and total mesorectum excision, are inappropriate for treating GISTs originating from the stomach, duodenum and rectum respectively.

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Section: Lesser Curvature and Gastro-oesophageal Junctionmentioning

confidence: 99%

Surgical management of gastrointestinal stromal tumours

Gervaz

Huber

Morel

2009

British Journal of Surgery

100

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“…El abordaje intragástrico encuentra su lugar en el caso de los GIST Tipo III, localizados en la curvatura menor o en la región de la unión esófago-gástrica (Tabla 1). Existen múlti-ples publicaciones constituidas por casos clínicos o pequeñas series de casos que han demostrado la seguridad y validez de este abordaje o de sus variaciones [10][11][12][13][14][15][16][17][18][19][20] . Recientemente, este procedimiento también se ha descrito mediante el uso de un solo puerto con la técnica Single Incision Laparoscopic Surgery (SILS) con buenos resultados [21][22][23][24] .…”

Section: Discussionunclassified

Resección Mixta Laparoscópica Y Endoscópica De Un Tumor Del Estroma Gastrointestinal De La Unión Gastroesofágica

Haito

et al. 2014

Rev Chil Cir

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resection of a gastrointestinal stromal tumor of the gastroesophagic junction using a mixed laparoscopic-endoscopic technique introduction:The ideal treatment for non-disseminated gastrointestinal stromal tumors (GIST) of the stomach is the local surgical resection. The laparoscopic approach has been validated showing its safety without compromising the oncological principles. The localization on the gastroesophagic junction is a specific situation on gastric GIST, mainly for submucosal tumors arising over the lesser curvature. Wedge resection of these tumors is technically demanding and has been associated to surgical complications and late development of stenosis and gastroesophageal reflux. For these reasons a mixed technique combining endoscopic and laparoscopic approaches has been developed. Herein we report a patient with an endophytic gastric GIST located on the gastroesophageal junction operated on with this technique. clinical case: A female 37-years old patient with a submucosal tumor of the gastroesophagic junction was submitted to laparoscopic surgery. During the surgical act the difficulty to continue with the laparoscopic resection became evident and the intragastric resection assisted with endoscopy was undertaken. The technique and the surgical outcomes are described. conclusion. The intragastric approach for submucosal tumors located over the gastroesophagic junction is safe and relatively simple. This technique is widely described in the medical literature and its indications validated.

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“…Laparoscopic surgery for GIST is a controversial approach because injury of the pseudo-capsule during a laparoscopic procedure can result in tumor dissemination. However, several groups of investigators have reported that laparoscopic surgery for GIST \5 cm in size was safe and suitable [4][5][6][7][8][9][10][11].…”

Section: Discussionmentioning

confidence: 99%

“…Various types of laparoscopic surgery for GIST have been described, including wedge resection of the stomach, intragastric tumor resection, and combined endoscopiclaparoscopic resection [4][5][6][7][8][9][10][11]. Wedge resection of the stomach is the ideal method for the GIST from the oncological aspect.…”

Section: Introductionmentioning

confidence: 99%

Laparoscopic wedge resection of the stomach for gastrointestinal stromal tumor (GIST): non-touch lesion lifting method

et al. 2013

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Background Laparoscopic surgery for GIST carries a risk of intraoperative tumor dissemination. To avoid tumor dissemination, we have utilized a ''non-touch'' method for surgical resection of GIST since 2000. Methods Forty-two patients with gastric GIST were treated at our institution between 2000 and 2012. Laparoscopic wedge resection of the stomach was used as the standard procedure for tumors that were 2-5 cm in size. Tumors larger than 5 cm were treated with open surgery. Our non-touch procedure included a lesion-lifting method using traction sutures at the normal stomach wall around the tumor. Intraoperative gastroscopy was utilized to confirm the location of the tumor with laparoscopy. After lifting of the tumor, tumors with a clear operative margin were resected using a linear stapler. Tumors located at the posterior wall of the stomach or located near the esophagogastric junction were resected using traction sutures. Results Median operative time was 140 min and median blood loss was 0 ml. Postoperative course was uneventful excepting one patient who experienced postoperative bleeding. The median postoperative stay was 7 days. One patient developed liver metastasis after surgery. None of the patients had local recurrence or peritoneal recurrence case. Conclusion This non-touch lesion-lifting method was useful for the surgical management of gastric GIST.

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Laparoscopic intragastric stapled resection of gastric submucosal tumors located near the esophagogastric junction

Abstract: Although we need to evaluate the long-term outcomes, our procedure is considered technically feasible, safe, and useful for the resection of gastric submucosal tumors located near the esophagogastric junction.

Cited by 87 publications

References 19 publications

Surgical management of gastrointestinal stromal tumours

Surgical management of gastrointestinal stromal tumours

Resección Mixta Laparoscópica Y Endoscópica De Un Tumor Del Estroma Gastrointestinal De La Unión Gastroesofágica

Laparoscopic wedge resection of the stomach for gastrointestinal stromal tumor (GIST): non-touch lesion lifting method

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