Journal of Gastric Cancer

  • 제15권4호
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  • Pages.278-285
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  • 2015
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  • 2093-582X(pISSN)
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  • 2093-5641(eISSN)
대한위암학회 (The Korean Gastric Cancer Association)
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Endoscopic and Laparoscopic Full-Thickness Resection of Endophytic Gastric Submucosal Tumors Very Close to the Esophagogastric Junction

  • Kwon, Oh Kyoung (Gastric Cancer Center, Kyungpook National University Medical Center) ;
  • Yu, Wansik (Gastric Cancer Center, Kyungpook National University Medical Center)
  • 투고 : 2015.11.26
  • 심사 : 2015.12.09
  • 발행 : 2015.12.31
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초록

Purpose: Gastric submucosal tumors (SMTs) located very close to the esophagogastric junction (EGJ) are a challenge for gastric surgeons. Therefore, this study reports on the experience of using endoscopic and laparoscopic full-thickness resection (ELFR) with laparoscopic two-layer suturing in such tumors. Materials and Methods: Six patients with gastric SMTs very close to the EGJ underwent ELFR with laparoscopic two-layer suturing at Kyungpook National University Medical Center. With the patient under general anesthesia, the lesser curvature and posterior aspect adjacent to the EGJ were meticulously dissected and visualized using a laparoscopic approach. A partially circumferential full-thickness incision at the distal margin of the tumor was then made using an endoscopic approach under laparoscopic guidance. The SMT was resected using laparoscopic ultrasonic shears, and the gastric wall was closed using two-layer suturing. Thereafter, the patency and any leakage were checked through endoscopy. Results: All the ELFR procedures with laparoscopic two-layer suturing were performed successfully without an open conversion. The mean operation time was $139.2{\pm}30.9$ minutes and the blood loss was too minimal to be measured. The tumors from four patients were leiomyomas, while the tumors from the other two patients were gastrointestinal stromal tumors with clear resection margins. All the patients started oral intake on the third postoperative day. There was no morbidity or mortality. The mean hospital stay was $7.7{\pm}0.8$ days. Conclusions: ELFR with laparoscopic two-layer suturing is a safe treatment option for patients with an SMT close to the EGJ, as major resection of the stomach is avoided.

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참고문헌

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피인용 문헌

  1. Endoscopic Full-Thickness Resection Combined with Laparoscopic Surgery vol.51, pp.1, 2015, https://doi.org/10.5946/ce.2017.153
  2. Transgastric and Reverse Sleeve Resection of Gastric Submucosal Tumors: Analysis of 7 Cases vol.91, pp.2, 2015, https://doi.org/10.1007/s13126-019-0511-5
  3. Laparoscopic Local Resection through Subserosal Dissection with Endoscopic Air-Insufflation for Submucosal Tumors Located Near the Esophagogastric Junction vol.23, pp.4, 2015, https://doi.org/10.7602/jmis.2020.23.4.172