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首页> 外文期刊>World Journal of Gastroenterology >Laparoscopic resection of submucosal tumor on posterior wall of gastric fundus
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Laparoscopic resection of submucosal tumor on posterior wall of gastric fundus

机译：腹腔镜切除胃底后壁粘膜下肿瘤

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AIM: Laparoscopic resection of tumors on the posterior wall of gastric fundus, especially when they are next to the esophagocardiac junction (ECJ), is both difficult and time-consuming. Furthermore, it can lead to inadvertent esophagus stenosis and injury to the spleen. In order to overcome these difficulties, laparoscopically extraluminal resection of gastric fundus was designed to manage submucosal tumors located on the posterior wall of gastric fundus and next to ECJ. METHODS: From January 2001 to September 2003, laparoscopically extraluminal resection of gastric fundus was successfully carried out on 15 patients. There were 11 males and 4 females with an average age of 58 years (range, 38 to 78 years). The mean diameter of the tumors was 4.8 cm. The distance of the tumor border from ECJ was about 1.5-2.5 cm. The four-portal operation procedures were as follows: localization of the tumor, dissection of the omentum, mobilization of the gastric fundus and the upper polar of spleen, exposure of ECJ, and resection of the gastric fundus with Endo GIA. RESULTS: The laparoscopic operation time averaged (66.2±10.4) min, the average amount of bleeding was (89.4±21.7) mL. The mean post-operative hospital stay was (5.3±1.1) d. Within 36 h post-operation, 73.3% of all the patients recovered their gastrointestinal function and began to eat something and to walk. In all the operations, no apparent tumor focus was left and no complication or conversion to open surgery occurred. CONCLUSION: Our newly designed procedure, laparoscopically extraluminal resection of the gastric fundus, can avoid contamination of the abdominal cavity, injury to the spleen and esophageal stenosis. The procedure seems to be both safe and effective.
机译：目的：腹腔镜切除胃底后壁的肿瘤非常困难且耗时，特别是当它们靠近食管心结（ECJ）时。此外，它还可能导致食管狭窄和脾脏损伤。为了克服这些困难，设计了腹腔镜下胃底腔内切除术，以处理位于胃底后壁上和ECJ旁的粘膜下肿瘤。方法：自2001年1月至2003年9月，成功对15例患者进行了腹腔镜下胃底切除术。男11例，女4例，平均年龄58岁（范围38至78岁）。肿瘤的平均直径为4.8cm。肿瘤边界距ECJ的距离约为1.5-2.5 cm。四门手术程序如下：肿瘤定位，大网膜剥离，胃底和脾上极的动员，ECJ的暴露以及Endo GIA切除胃底。结果：腹腔镜手术时间平均为（66.2±10.4）min，平均出血量为（89.4±21.7）mL。术后平均住院时间为（5.3±1.1）d。术后36小时内，所有患者的73.3％恢复了胃肠功能，开始进食和行走。在所有手术中，没有留下明显的肿瘤灶，也没有发生并发症或转为开放手术。结论：我们新设计的手术方法是通过腹腔镜行胃底腔外切除术，可避免腹腔污染，脾脏和食管狭窄。该程序似乎既安全又有效。

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