Purpose : In gastric diseases that do not require a radical surgery, the laparoscopic method offers a minimally invasive approach to treat them with all the known benefits of this modality. Although initially it was only applied to benign gastric diseases, nowadays carefully selected malignancies are also included. The porpose of our study was to demonstrate the feasibility and safety of this modality.
Methods : From February 1997 to December 2002, thirt-one patients with diverse gastric tumors treated laparoscopically were included in this study. Totally laparoscopic or laparoscopic-assisted methods were applied and intraoperative endoscopic tumor localization was performed as needed. Tumors were resected using laparoscopic stapling devices or by excision-suture method.
Results : The mean age of the patients was 52.1±13.5 years. Twenty-six were benign and five, malignant. Gastrointestinal stromal tumor was the most frequent disease, followed by ectopic pancreas and leiomyoma. Among malignancies, there were two early gastric cancers. Mean operative time was 170.4±64.2 min and hospital stay, 5.7±2.2 days. There were two complications (transient bleeding through nasogastric tube and paralytic ileus), but all improved with conservative management. Only one patient was converted to open surgery. To date, no evidence of recurrence is noted on 7.8 (1~60) months of follow-up.
Conclusion : Laparoscopic gastric resection is feasible and safe for diverse benign gastric diseases and some carefully selected malignant diseases; however, for malignant cases, strict inclusion criteria must be defined and oncologic principles must be respected.
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