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首页> 外文期刊>Surgical Endoscopy >Laparoscopic and endoscopic cooperative surgery for gastrointestinal stromal tumor dissection.
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Laparoscopic and endoscopic cooperative surgery for gastrointestinal stromal tumor dissection.

机译：腹腔镜和内窥镜合作手术治疗胃肠道间质瘤。

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BACKGROUND: Laparoscopic wedge resections are increasingly applied for gastric submucosal tumors such as gastrointestinal stromal tumor (GIST). Despite this, no defined strategy exists to guide the surgeon in choosing the appropriate laparoscopic technique for an individual case on the basis of tumor characteristics such as location or size. This study aimed to introduce a laparoscopic and endoscopic cooperative surgery (LECS) for gastric wedge resection that is applicable for submucosal tumor resection independent of tumor location and size. METHODS: Seven patients underwent LECS for the resection of gastric submucosal tumors. Both mucosal and submucosal layers around the tumor were circumferentially dissected using endoscopic submucosal dissection via intraluminal endoscopy. Subsequently, the seromusclar layer was laparoscopically dissected on the exact three-fourths cut line around the tumor. The submucosal tumor then was exteriorized to the abdominal cavity and dissected with a standard endoscopic stapling device. RESULTS: In all cases, the LECS procedure was successful for dissecting out the gastric submucosal tumor. In four of seven cases, the tumor was located in the upper gastric portion near the esophagogastric junction. The remaining three tumors were in the posterior gastric wall. In two cases, the tumors were more than 5 cm in diameter, and one was a GIST of the remnant stomach. The mean operation time was 169 +/- 17 min, and the estimated blood loss was 7 +/- 2 ml. The postoperative course was uneventful in all cases. CONCLUSIONS: The LECS procedure for dissection of gastric submucosal tumors such as GIST may be performed safely with reasonable operation times, less bleeding, and adequate cut lines. In addition, the success of the procedure does not depend on the tumor location such as the vicinity of the esophagogastric junction or pyloric ring.
机译：背景：腹腔镜楔形切除术越来越多地用于胃黏膜下肿瘤，如胃肠道间质瘤（GIST）。尽管如此，尚无确定的策略可指导外科医生根据肿瘤特征（如位置或大小）为个别病例选择合适的腹腔镜技术。这项研究旨在介绍一种适用于胃楔形切除术的腹腔镜和内窥镜合作手术（LECS），该手术适用于粘膜下肿瘤切除术，与肿瘤的位置和大小无关。方法：7例行LECS切除胃黏膜下肿瘤。肿瘤内的粘膜层和粘膜下层均通过腔内镜通过内镜下粘膜下剥离术进行周向解剖。随后，在肿瘤周围精确的四分之三的切割线上，腹腔镜解剖血清肌层。然后将粘膜下肿瘤外化至腹腔，并用标准内窥镜缝合器械解剖。结果：在所有情况下，LECS手术均成功切除了胃黏膜下肿瘤。在7例中的4例中，肿瘤位于食管胃交界处附近的胃上部。其余三个肿瘤位于胃后壁。在两种情况下，肿瘤直径超过5厘米，一种是残余胃部的GIST。平均手术时间为169 +/- 17分钟，估计失血为7 +/- 2毫升。术后过程在所有情况下均顺利。结论：LECS手术可切除胃黏膜下肿瘤（如GIST），且手术时间合理，出血少，切线适当，可安全进行。此外，手术的成功与否取决于肿瘤的位置，例如食管胃交界处或幽门环附近。

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