J Minim Invasive Surg.  2020 Dec;23(4):172-178. 10.7602/jmis.2020.23.4.172.

Laparoscopic Local Resection through Subserosal Dissection with Endoscopic Air-Insufflation for Submucosal Tumors Located Near the Esophagogastric Junction

Affiliations
  • 1Department of Surgery, Gyeongsang National University Hospital, College of Medicine, Gyeongsang National University, Jinju, Korea
  • 2Department of Surgery, Gyeongsang National University Changwon Hospital, College of Medicine, Gyeongsang National University, Changwon, Korea

Abstract

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.

Keyword

Laparoscopy; Stomach neoplasm; Gastrointestinal stromal tumor; Esophagogastric junction; Endoscopy
Full Text Links
  • JMIS
Actions
Cited
CITED
export Copy
Close
Share
  • Twitter
  • Facebook
Similar articles
Copyright © 2022 by Korean Association of Medical Journal Editors. All rights reserved.     E-mail: koreamed@kamje.or.kr