Abstract/References
Clinical outcomes of laparoscopic and endoscopic cooperative surgery for gastric gastrointestinal stromal tumor
Hiroyuki Hanayama, Masanori Katagata, Takahiro Sato, Hiroshi Nakano, Takuro Matsumoto, Takeshi Tada, Yohei Watanabe, Suguru Hayase, Hirokazu Okayama, Tomoyuki Momma, Tsunetaka Kato, Minami Hashimoto, Jun Nakamura, Takuto Hikichi, Zenichiro Saze, Koji Kono
Author information
- Hiroyuki Hanayama
Department of Gastrointestinal Tract Surgery, Fukushima Medical University - Masanori Katagata
Department of Gastrointestinal Tract Surgery, Fukushima Medical University - Takahiro Sato
Department of Gastrointestinal Tract Surgery, Fukushima Medical University - Hiroshi Nakano
Department of Gastrointestinal Tract Surgery, Fukushima Medical University - Takuro Matsumoto
Department of Gastrointestinal Tract Surgery, Fukushima Medical University - Takeshi Tada
Department of Gastrointestinal Tract Surgery, Fukushima Medical University - Yohei Watanabe
Department of Gastrointestinal Tract Surgery, Fukushima Medical University - Suguru Hayase
Department of Gastrointestinal Tract Surgery, Fukushima Medical University - Hirokazu Okayama
Department of Gastrointestinal Tract Surgery, Fukushima Medical University - Tomoyuki Momma
Department of Gastrointestinal Tract Surgery, Fukushima Medical University - Tsunetaka Kato
Department of Endoscopy, Fukushima Medical University Hospital - Minami Hashimoto
Department of Endoscopy, Fukushima Medical University Hospital - Jun Nakamura
Department of Endoscopy, Fukushima Medical University Hospital - Takuto Hikichi
Department of Endoscopy, Fukushima Medical University Hospital - Zenichiro Saze
Department of Gastrointestinal Tract Surgery, Fukushima Medical University - Koji Kono
Department of Gastrointestinal Tract Surgery, Fukushima Medical University
Abstract
Background:Laparoscopic and endoscopic cooperative surgery (LECS) is a well-recognized surgical procedure for gastric gastrointestinal stromal tumor (GIST). In this report, we describe the clinical outcomes of LECS procedures for gastric GIST in our institution.
Methods:We performed LECS procedures, including classical LECS, inverted LECS, closed LECS, and combination of laparoscopic and endoscopic approaches to neoplasia with non-exposure technique (CLEAN-NET), in 40 gastric intraluminal and intramural type GIST patients, whose tumors were ≤ 50 mm in diameter, between September 2012 and December 2020. The patient background, surgical outcomes, postoperative morbidity and mortality, as well as the tumors’ clinicopathological characteristics were analyzed retrospectively.
Results:Pathological findings showed that most patients had a low or very low risk of tumor recurrence, while one patient had a high risk according to the modified-Fletcher’s classification. The median length of postoperative hospital stay was 7 days. Only one patient had severe postoperative grade III complications according to the Clavien-Dindo (C-D) classification, after closed LECS, but was treated successfully with endoscopic hemostasis for postoperative hemorrhage. The remaining patients treated with LECS did not have severe complications. During the follow-up period (median, 31 months), all patients were disease-free, with no tumor recurrence or metastases.
Conclusion:LECS is a safe surgical procedure for gastric intraluminal and intramural type GIST ≤ 50 mm in diameter, with good clinical outcomes.
References
- Koo DH, Ryu MH, Kim KM, et al. Asian consensus guidelines for the diagnosis and management of gastrointestinal stromal tumor. Cancer Res Treat, 48(4):1155-1166, 2016.
- Namikawa T, Hanazaki K. Laparoscopic endoscopic cooperative surgery as a minimally invasive treatment for gastric submucosal tumor. World J Gastrointest Endosc, 7(14):1150-1156, 2015.
- Waseda Y, Doyama H, Inaki N, et al. Does laparoscopic and endoscopic cooperative surgery for gastric submucosal tumors preserve residual gastric motility? Results of a retrospective single-center study. PLoS One, 26; 9(6):e101337, 2014.
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