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KMID : 1035920200230040172
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Journal of Minimally Invasive Surgery
2020 Volume.23 No. 4 p.172 ~ p.178
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Laparoscopic Local Resection through Subserosal Dissection with Endoscopic Air-Insufflation for Submucosal Tumors Located Near the Esophagogastric Junction
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Kim In-Kyeong
Park Ji-Ho
Lee Young-Joon
Jeong Sang-Ho
Kim Tae-Han
Kim Dong-Hwan
Kim Han-Gil
Cho Jin-Kyu
Kim Jae-Myung
Kwag Seung-Jin
Kim Ju-Yeon
Jeong Chi-Young
Ju Young-Tae
Jung Eun-Jung
Hong Soon-Chan
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Abstract
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Purpose: A novel resection method, namely, laparoscopic local resection through subserosal dissection with endoscopic air-insuff lation (LRSDEA) was used for submucosal tumors located near the esophagogastric junction (SMT-EGJ) to avoid major gastric resection.
Methods: A total of 9 cases underwent LRSDEA. We sequentially performed: laparoscopic dissections around EGJ, subserosal dissections around SMTs using laparoscopic electrocautery and ultrasonic shears, and finally, enucleation of SMTs. During these procedures, intraoperative endoscopic tumor localization, as well as endoscopic air-insufflation allowed for safe resection. These procedures are shown in the supplementary video clip. The clinicopathological characteristics and surgical results were analyzed.
Results: All laparoscopic procedures were successfully performed without requiring a major gastrectomy. The mean operation time was 126.1 minutes, and estimated blood loss was 12.0 ml. There were no postoperative complications. Pathological diagnoses were 6 leiomyomas, 2 gastrointestinal stromal tumors, and 1 gastric duplication.
Conclusion: LRSDEA is an effective and safe treatment option for SMT-EGJ, as major resection of the stomach is avoided.
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KEYWORD
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Laparoscopy, Stomach neoplasm, Gastrointestinal stromal tumor, Esophagogastric junction, Endoscopy
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