Laparoscopic Local Resection through Subserosal Dissection with Endoscopic Air-Insufflation for Submucosal Tumors Located Near the Esophagogastric Junction
10.7602/jmis.2020.23.4.172
- Author:
In-Kyeong KIM
1
;
Ji-Ho PARK
;
Young-Joon LEE
;
Sang-Ho JEONG
;
Tae Han KIM
;
Dong-Hwan KIM
;
Han-Gil KIM
;
Jin-Kyu CHO
;
Jae-Myung KIM
;
Seung-Jin KWAG
;
Ju-Yeon KIM
;
Chi-Young JEONG
;
Young-tae JU
;
Eun-Jung JUNG
;
Soon-Chan HONG
Author Information
1. Department of Surgery, Gyeongsang National University Hospital, College of Medicine, Gyeongsang National University, Jinju, Korea
- Publication Type:ORIGINAL ARTICLE
- From:Journal of Minimally Invasive Surgery
2020;23(4):172-178
- CountryRepublic of Korea
- Language:English
-
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.
