Laparoscopic Wedge Resection of Gastric Submucosal Tumors

Abstract

Background/Aims: The purpose of this study was to evaluate the clinical utility of laparoscopic surgery for gastric submucosal tumor. Methods: The records of 11 patients who underwent laparoscopic wedge resection (LR group) for gastric submucosal tumors were reviewed and compared with those of 8 patients who underwent open surgery (OS group). Results: Mean operation time was 145 ± 43 min in the LR group and 127 ± 33 min in the OS group (p = 0.301). Mean blood loss was 97 ± 107 and 107 ± 47 g, respectively (p = 0.387). Patients in the LR group began walking 1.4 ± 0.7 days after surgery, which was significantly earlier than those in the OS group (2.7 ± 1.3 days, p = 0.021). The first flatus (1.5 ± 0.5 vs. 3.1 ± 0.6 days, respectively, p = 0.0004) and resumption of oral food intake (3.0 ± 1.7 vs. 4.3 ± 0.9 days, respectively, p = 0.020) were also earlier in the LR group. White blood cell count on the first postoperative day was lower (7,000 ± 2,100 vs. 11,900 ± 3,580/mm³, respectively, p = 0.004) in the LR group than in the OS group, and the duration of fever (>38.0°C; 0.1 ± 0.3 vs. 0.9 ± 0.8 days, respectively, p = 0.014) and the period of postoperative hospitalization (13.2 ± 3.7 vs. 20.8 ± 6.1 days, respectively, p = 0.014) were significantly shorter in the LR group than in the OS group. No complications occurred in either group. Conclusion: Laparoscopic surgery was superior to open surgery in terms of postoperative recovery time with comparable operation time and blood loss. Laparoscopic wedge resection is a promising surgical alternative for the treatment of gastric submucosal tumors.

Laparoscopic Wedge Resection for Gastrointestinal Stromal Tumors of the Stomach: Initial Experience

“…Intraoperative gastroscopy is therefore used widely in laparoscopic surgery for gastric GISTs, for identifying and marking tumors, ensuring sufficient margins, and preventing luminal stenosis. 14,28,33 In conclusion, as long as patients are carefully selected, laparoscopic surgery is feasible for resecting GISTs of the stomach, resulting in faster recovery, even when performed by surgeons with limited experience in advanced laparoscopic procedures.…”

Laparoscopic Wedge Resection for Gastric Submucosal Tumors: A Size-Location Matched Case-Control Study

“…5 Yet, LWR for gastric GISTs smaller than 5 cm has become a popular and feasible surgical procedure in Eastern countries. 11,14,15 Additionally, modified wedge resections, such as the transgastric technique, and extensive resections, such as distal gastrectomy, have been applied to laparoscopic procedures, depending on the location of the tumor. 6,13,16 To overcome the debate on the operation and the standardization of diverse operations according to size and location, we designed a case-control study matching size and location based on 50 LWR patients.…”

“…As mentioned, although there have been studies to show the benefits of the laparoscopic wedge approach, they did not have enough patients and did not indicate the size or location of gastric SMTs. 3,11,17 By careful case-matching, we analyzed a total of 100 procedures consisting of 50 LWRs and 50 OWRs. In size-matching, tumors between 2 and 5 cm accounted for the largest proportion (68%), and tumors larger than 5 cm accounted for 12%; the largest diameter in the LWR group was 6 cm.…”

Simultaneous use of gastroscopy and laparoscopy for resection of gastrointestinal stromal tumors

“…Although the incidence in the community is unknown, the incidence is thought to be 1 in 100,000. [1,2] GISTs can locate in any portion of the gastrointestinal tract from esophagus to rectum. [3] In non-metastatic GISTs, the primary treatment option is surgery.…”