Preliminary analysis of hybrid laparoscopic procedure for resection of gastric submucosal tumors

Caron, Pedro Henrique Lambach; Martins, Mariana Ismael Dias; Bertevello, Pedro Luiz

doi:10.1590/0100-69912016002010

Cited by 4 publications

(3 citation statements)

References 19 publications

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“…Based on qualified randomized controlled trials (RCTs), Obuchi et al investigated the overall efficacy and safety of anterior laparoscopic surgery and traditional open surgery in patients with colorectal cancer, especially the difference in the incidence of postoperative deep vein thrombosis (DVT) [ 1 ]. Caron et al compared the efficacy of traditional open surgery and laparoscopic surgery in the treatment of rectal cancer [ 2 ]. Single incision gastric surgery is used for various diseases such as gastric tumor and pancreatic pseudocyst [ 3 ].…”

Section: Introductionmentioning

confidence: 99%

Clinical Effect Analysis of Laparoscopic Surgery for Gastric Tumor under Data Mining

Huang

Guo

Yin

et al. 2021

Journal of Healthcare Engineering

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This paper mainly analyzes the feasibility of laparoscopic local gastrectomy for the treatment of benign gastric tumors, evaluating its curative effect, and the use of traditional Chinese medicine (TCM) such as Hedyotis diffusa, Radix Pseudostellariae, yi, Pinellia ternata, Ophiopogon japonicus, wood fragrance, Perilla, Scutellaria baicalensis, Yuzhu, hawthorn, Artemisia annua, chicken yellow film, nail, and turtle, and clinical symptoms of statistical analysis of data mining. A total of 86 patients with gastric benign tumor were selected as the research object and were divided into observation group and control group with 43 cases in each by the random number table method. The control group received radical gastrectomy for benign tumor under laparoscopy, while the observation group received local gastrectomy under laparoscopy. Perioperative indexes such as operative time, intraoperative blood loss, and length of hospital stay were recorded in the two groups. Serum C-reactive protein (CRP) and carcinoembryonic antigen (CEA) levels were analyzed by enzyme-linked immunosorbent assay (ELISA), and the incidence of complications was compared. Based on the clinical analysis of the drug used, the results of association significance were selected, and the top ten results were selected in order of confidence and grouped according to clinical symptoms, respectively, as follows: (1) abdominal distension: Hedyotis diffusa, Radix Pseudostellariae, Poria cocos, Huckleberry, and Coix seed; (2) dry mouth: Poria cocos, Radix Radix Pseudostellariae, Coix seed, Pinellia tuber, and Radix Ophiopogonis. The results showed that the minimum operation time in the observation group was 159.7 ± 13.07 min and the maximum was 172.57 ± 2.47 min, which was lower than that in the control group (the minimum was 172.46 ± 12.45 min and the maximum was 186.49 ± 24.32 min). The length of hospital stay (6.51 ± 1.29 days) was lower than that in the control group (7.56 ± 1.42 days) (P < 0.05). The CEA and CRP levels decreased significantly in both groups after treatment ( P < 0.05 ). However, the observation group’s CEA was (4.21 ± 1.05) mg/L and CRP was (8.46 ± 1.25) μg/L. In the control group, CEA was (4.18 ± 1.02) mg/L and CRP was (8.39 ± 1.24) μg/L. There were no significant differences ( P < 0.05 ). The incidence of complications in the observed group was 4.7% lower than 7.0% in the control group ( P < 0.05 ). Therefore, laparoscopic local gastric resection for benign gastric tumors can effectively reduce the incidence of CEA and CRP level and complications and improve the perioperative indicators, which is worth popularizing in clinical practice.

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Section: Introductionmentioning

confidence: 99%

Clinical Effect Analysis of Laparoscopic Surgery for Gastric Tumor under Data Mining

Huang

Guo

Yin

et al. 2021

Journal of Healthcare Engineering

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“…This technique aims to accumulate the strong points of intraluminal and intraperitoneal procedures and negate the technical limitations[ 3 ]. This novel concept has been described using different names ( e.g ., hybrid laparoscopic, combined laparoscopic and endoscopic, laparoscopic-endoscopic rendezvous, and cooperative laparoscopicendoscopic procedures)[ 3 , 19 - 21 ]; however, use of these multiple terms might confuse endoscopic physicians and general surgeons. Despite the differing names, this hybrid concept focuses on a simultaneous approach via intraluminal and intraperitoneal pathways, subsequent precise resection with oncologic principles, and physiological closure of the defect[ 3 , 22 , 23 ].…”

Section: Introductionmentioning

confidence: 99%

Laparoscopic and endoscopic cooperative surgery for gastric tumors: Perspective for actual practice and oncological benefits

Aisu¹,

Yasukawa²,

Kimura³

et al. 2018

WJGO

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Laparoscopic and endoscopic cooperative surgery (LECS) is a surgical technique that combines laparoscopic partial gastrectomy and endoscopic submucosal dissection. LECS requires close collaboration between skilled laparoscopic surgeons and experienced endoscopists. For successful LECS, experience alone is not sufficient. Instead, familiarity with the characteristics of both laparoscopic surgery and endoscopic intervention is necessary to overcome various technical problems. LECS was developed mainly as a treatment for gastric submucosal tumors without epithelial lesions, including gastrointestinal stromal tumors (GISTs). Local gastric wall dissection without lymphadenectomy is adequate for the treatment of gastric GISTs. Compared with conventional simple wedge resection with a linear stapler, LECS can provide both optimal surgical margins and oncological benefit that result in functional preservation of the residual stomach. As technical characteristics, however, classic LECS involves intentional opening of the gastric wall, resulting in a risk of tumor dissemination with contamination by gastric juice. Therefore, several modified LECS techniques have been developed to avoid even subtle tumor exposure. Furthermore, LECS for early gastric cancer has been attempted according to the concept of sentinel lymph node dissection. LECS is a prospective treatment for GISTs and might become a future therapeutic option even for early gastric cancer. Interventional endoscopists and laparoscopic surgeons collaboratively explore curative resection. Simultaneous intraluminal approach with endoscopy allows surgeons to optimizes the resection area. LECS, not simple wedge resection, achieves minimally invasive treatment and allows for oncologically precise resection. We herein present detailed tips and pitfalls of LECS and discuss various technical considerations.

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“…As time passed, the endoscopic technique was developed, and gradually, collaborative surgery (endoscopic mucosal resection and endoscopic submucosal dissection [ESD]) was performed [ 4 ]. In addition, the procedure for resecting only benign gastric tumors, such as submucosal tumors (SMTs), moved to the stage of resecting malignant tumors, such as early gastric cancer (EGC) [ 5 6 ]. Endoscopic full-thickness resection (EFTR) has been performed for curative resection of EGC [ 4 7 8 ].…”

Section: Introductionmentioning

confidence: 99%

Choice of LECS Procedure for Benign and Malignant Gastric Tumors

2021

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Laparoscopic endoscopic cooperative surgery (LECS) refers to the endoscopic dissection of the mucosal or submucosal layers with laparoscopic seromuscular resection. We recommend a treatment algorithm for the LECS procedure for gastric benign tumors according to the protruding type. In the exophytic type, endoscopic-assisted wedge resection can be performed. In the endophytic type, endoscopic-assisted wedge resection of the anterior wall is relatively easy to perform, and endoscopic-assisted transgastric resection, laparoscopic-assisted intragastric surgery, or single-incision intragastric resection in the posterior wall and esophagogastric junction (EG Jx) can be attempted. We propose an algorithm for the LECS procedure for early gastric cancer according to the tumor location. The endoscopic submucosal dissection (ESD) procedure can be adapted for all areas of the stomach, and single-incision ESD can be performed in the mid to high body and the EG Jx. In full-thickness gastric resection, laparoscopy-assisted endoscopic full-thickness resection can be adapted for the entire area of the stomach, but it cannot be applied to the pyloric and EG Jx. In conclusion, surgeons need to select the LECS procedure according to tumor type, tumor location, the surgeon's individual experience, and the situation of the institution while also considering the advantages and disadvantages of each procedure.

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Preliminary analysis of hybrid laparoscopic procedure for resection of gastric submucosal tumors

Cited by 4 publications

References 19 publications

Clinical Effect Analysis of Laparoscopic Surgery for Gastric Tumor under Data Mining

Clinical Effect Analysis of Laparoscopic Surgery for Gastric Tumor under Data Mining

Laparoscopic and endoscopic cooperative surgery for gastric tumors: Perspective for actual practice and oncological benefits

Choice of LECS Procedure for Benign and Malignant Gastric Tumors

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