Single-port laparoscopic and endoscopic cooperative surgery for a gastric gastrointestinal stromal tumor: report of a case

Obuchi, Toru; Sasaki, Akira; Baba, Shigeaki; Nitta, Hiroyuki; Otsuka, Koki; Wakabayashi, Go

doi:10.1007/s00595-014-0870-z

Cited by 13 publications

(7 citation statements)

References 21 publications

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“…9,10 However, laparoscopic manipulation only with a single port is not easy and could not be adequate when the tumors are located at difficult sites to be approached from laparoscopic insertion sites such as the posterior wall or the remote sites from the laparoscopy. The additional studies to resolve these problems should be needed for clinical application.…”

Section: Laparoscopy and Endoscopy Cooperative Surgery (Lecs)mentioning

confidence: 99%

Recent development of innovative resection methods for gastric neoplasms using hybrid natural orifice transluminal endoscopic surgery approach

Lim

2017

Int J Gastrointest Interv

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There have been an evolutionary development with respect to the resection modality for the treatment of the gastric neoplasms such as gastric subepithelial tumors (SETs) or early gastric cancers (EGCs). Hybrid natural orifice transluminal endoscopic surgery (hybrid NOTES) played a central role in the process of development. In the earlier period, the non-exposure type hybrid NOTES such as laparoscopy and endoscopy cooperative surgery (LECS), endoscope-assisted wedge resection (EAWR), and laparoscopy-assisted endoscopic full-thickness resection (LAEFTR) has been introduced by several investigators. However, a concern about a spillage of gastric content including the tumor cells has been continuously raised among the clinicians. Accordingly, the non-exposure type hybrid NOTES such as combination of laparoscopic and endoscopic approaches to neoplasia with a nonexposure technique (CLEAN-NET), non-exposed endoscopic wall-inversion surgery (NEWS), and hybrid neo-endoscopic full-thickness resection (hybrid neo-EFTR) have been developed to the clinicians. Although most of studies about hybrid NOTES for the treatment of the gastric neoplasms have a small number of patients and require further validations, those are enough to receive our attention. Here, we describe and summarize the development process of the innovative resection methods for gastric neoplasms using hybrid NOTES approach.

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Section: Laparoscopy and Endoscopy Cooperative Surgery (Lecs)mentioning

confidence: 99%

Recent development of innovative resection methods for gastric neoplasms using hybrid natural orifice transluminal endoscopic surgery approach

Lim

2017

Int J Gastrointest Interv

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“…The primary goal of surgical treatment for GISTs is to achieve resection of the tumor with a negative margin [ 10 ]. Recently, combined laparoendoscopic approaches, such as LECS and EFTR, have been developed to avoid stenosis and deformity of the gastric cardia after surgery [ 7 – 9 ]. In addition, percutaneous endoscopic intragastric surgery (PEIGS) has been reported for gastric submucosal tumors [ 11 ].…”

Section: Case Presentationmentioning

confidence: 99%

“…However, as much of the normal gastric wall around the tumor may be removed in LWR for GIST, severe deformity and stenosis of the stomach and disturbance of gastric function often occur after LWR, especially for GIST at the esophagogastric junction (EGJ). Recently, combined laparoendoscopic approaches, such as laparoscopy-endoscopy cooperative surgery (LECS) and endoscopic full thickness resection (EFTR), have been developed in order to prevent postoperative deformities and stenosis of the EGJ [ 7 – 9 ].…”

Section: Introductionmentioning

confidence: 99%

A gastrointestinal stromal tumor at the esophagogastric junction successfully treated by laparoscopic wedge resection with seromuscular layer dissection: a case report

et al. 2015

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Herein, we report a case of a gastrointestinal stromal tumor (GIST) at the esophagogastric junction (EGJ) that was successfully treated by a laparoscopic wedge resection (LWR) after dissection of the seromuscular layer around the tumor to prevent postoperative deformities and stenosis of the EGJ. Subsequently, the abdominal esophagus was wrapped by the gastric fornix according to Dor’s method in order to prevent reflux esophagitis after surgery.A 71-year-old female patient was admitted with a diagnosis of a GIST (23 × 20 × 20 mm) at the EGJ. We performed the abovementioned operation.Gastroduodenal endoscopic examination revealed no deformity or stenosis of the EGJ at 6 months after the operation. The patient has not experienced any reflux symptoms. Tumor recurrence was not noted 26 months after the operation.This procedure is useful in preventing the deformity and stenosis of the EGJ as well as postoperative reflux esophagitis.

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“…We developed a laparoscopic endoscopic cooperative surgery (LECS) procedure, combining the technique of endoscopic submucosal dissection (ESD), to determine the exact cutting line, and laparoscopic gastric wall resection, and have used this procedure to resect gastric submucosal tumors (SMTs). After we first reported LECS in 2008, many researchers have used this procedure . They reported that LECS is safe and feasible for gastric SMTs, and that LECS can be used in most patients, regardless of tumor location .…”

Section: Introductionmentioning

confidence: 99%

Laparoscopic endoscopic cooperative surgery (LECS) for the gastrointestinal tract: Updated indications

Hiki

Nunobe

2019

Annals of Gastroent Surgery

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Laparoscopic and endoscopic cooperative surgery (LECS) is a procedure combining laparoscopic gastric resection with endoscopic submucosal dissection for local resection of gastric tumors with appropriate, minimal surgical resection margins. The LECS concept was initially developed from the classical LECS procedure for gastric submucosal tumor resection. Many researchers reported that classical LECS was a safe and feasible technique for resection of gastric submucosal tumors, regardless of tumor location, including the esophagogastric junction. Recently, LECS was approved for insurance coverage by Japan's National Health Insurance plan and widely applied for gastric submucosal tumor resection. However, the limitations of classical LECS are the risk of abdominal infection, scattering of tumor cells in the abdominal cavity, and tumor cell seeding in the peritoneum. The development of modified LECS procedures, such as inverted‐LECS, non‐exposed endoscopic wall‐inversion surgery, a combination of laparoscopic and endoscopic approaches to neoplasia with a non‐exposure technique, and closed‐LECS, has almost resolved these drawbacks. This has led to a recent increase in the indication of modified LECS to include patients with gastric epithelial neoplasms. The LECS concept is also beginning to be applied to tumor excision in other organs, such as the duodenum, colon and rectum. Further evolution of LECS procedures is expected in the future. Sentinel lymph node mapping could also be combined with LECS, resulting in a portion of early gastric cancers being treated by LECS with sentinel node mapping.

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Single-port laparoscopic and endoscopic cooperative surgery for a gastric gastrointestinal stromal tumor: report of a case

Cited by 13 publications

References 21 publications

Recent development of innovative resection methods for gastric neoplasms using hybrid natural orifice transluminal endoscopic surgery approach

Recent development of innovative resection methods for gastric neoplasms using hybrid natural orifice transluminal endoscopic surgery approach

A gastrointestinal stromal tumor at the esophagogastric junction successfully treated by laparoscopic wedge resection with seromuscular layer dissection: a case report

Laparoscopic endoscopic cooperative surgery (LECS) for the gastrointestinal tract: Updated indications

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