Endoscopy 2017; 49(05): 476-483
DOI: 10.1055/s-0043-104526
Original article
© Georg Thieme Verlag KG Stuttgart · New York

Laparoscopic and luminal endoscopic cooperative surgery can be a standard treatment for submucosal tumors of the stomach: a retrospective multicenter study

Tatsuo Matsuda
1   Department of Gastroenterological Surgery, Cancer Institute Ariake Hospital, Japanese Foundation for Cancer Research, Tokyo, Japan
,
Souya Nunobe
1   Department of Gastroenterological Surgery, Cancer Institute Ariake Hospital, Japanese Foundation for Cancer Research, Tokyo, Japan
,
Toshiyuki Kosuga
1   Department of Gastroenterological Surgery, Cancer Institute Ariake Hospital, Japanese Foundation for Cancer Research, Tokyo, Japan
2   Division of Digestive Surgery, Department of Surgery, Kyoto Prefectural University of Medicine, Kyoto, Japan
,
Hiroshi Kawahira
3   Department of Frontier Surgery, Chiba University Graduate School of Medicine, Chiba, Japan
,
Noriyuki Inaki
4   Department of Gastroenterological Surgery, Ishikawa Prefectural Central Hospital, Kanazawa, Japan
,
Shuji Kitashiro
5   Department of Surgery, Tonan Hospital, Sapporo, Japan
,
Nobutsugu Abe
6   Department of Surgery, Kyorin University School of Medicine, Tokyo, Japan
,
Isao Miyashiro
7   Center for Cancer Control and Statistics, Osaka Medical Center for Cancer and Cardiovascular Diseases, Osaka, Japan
,
Sayaka Nagao
8   Department of Surgery, Toho University Ohashi Medical Center, Tokyo, Japan
,
Masahiko Nishizaki
9   Department of Gastroenterological Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan.
,
Naoki Hiki
1   Department of Gastroenterological Surgery, Cancer Institute Ariake Hospital, Japanese Foundation for Cancer Research, Tokyo, Japan
,
Society for the Study of Laparoscopy and Endoscopy Cooperative Surgery › Institutsangaben
Weitere Informationen

Publikationsverlauf

submitted 14. Mai 2016

accepted after revision 17. November 2016

Publikationsdatum:
10. April 2017 (online)

Abstract

Background and study aims We have developed a combined laparoscopic and luminal endoscopic surgery technique for resection of gastric submucosal tumors (SMTs) that can be performed without excessive resection of the stomach. In a multicenter retrospective study we aimed to evaluate the feasibility and safety of laparoscopic and endoscopic cooperative surgery (LECS) for gastric SMT resection.

Patients and methods Between October 2007 and December 2011, 126 patients with gastric SMTs underwent LECS at 8 institutions. Patient demographics, tumor histopathologic characteristics, and operative and follow-up data were reviewed.

Results 16 tumors (12.7 %) were located in the upper third of the stomach, 88 (69.8 %) in the middle third, 5 (4.0 %) in the lower third, and 17 (13.5 %) at the esophagogastric junction. The mean (standard deviation [SD]) operation time for LECS was 190.2 (66.8) min, with a mean estimated blood loss of 15.1 (38.6) mL. In 2 cases (1.6 %), the procedure was converted to open surgery because of intra-abdominal adhesions or stenosis. Morbidity was found in 6 cases (4.8 %), including 2 leakage, 2 gastric stasis, 1 fever, and 1 cystitis. Histologically, a gastrointestinal stromal tumor (GIST) was found in 86 (68.3 %) cases. The median follow-up period was 54.7 months; no local or distant tumor recurrence was observed and all patients were alive.

Conclusions LECS proved to be a safe and feasible procedure for the resection of gastric SMTs, with a reasonable operation time, low bleeding, and an acceptable complication rate in this multicenter study in Japan.

 
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