Journal of Gastric Cancer

The Korean Gastric Cancer Association (대한위암학회)
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Choice of LECS Procedure for Benign and Malignant Gastric Tumors

  • Min, Jae-Seok (Department of Surgery, Dongnam Institute of Radiological and Medical Sciences, Cancer Center) ;
  • Seo, Kyung Won (Department of Surgery, Kosin University Gospel Hospital) ;
  • Jeong, Sang-Ho (Department of Surgery, Gyeongsang National University Changwon Hospital, Gyeongsang National University School of Medicine)
  • Received : 2021.06.06
  • Accepted : 2021.06.21
  • Published : 2021.06.30
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Abstract

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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References

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