|
|
|
|
Back to Scientific Program
Back to Annual Meeting
Endoscopically assisted Laparoscopic Resections of Submucosal Gastric and GE Junction Tumors- A Novel Approach to Resection Based on Tumor Location.
Laurence E McCahill1, Alicia Privette1, Rick Zubarik1, Nicole Messier2, Edward Borrazzo1
1University of Vermont, Burlington, VT;2Fletcher Allen Health Care, Burlington, VT
Objectives: To identify endoscopic features of submucosal gastric tumors that determine the appropriate laparoscopic approach for definitive tumor resection.
Design: Retrospective Observational Study
Setting: Tertiary Care, University-based Hospital
Patients: All consecutive patients with submucosal gastric tumors seen from Jan 2005 through March 2006.
Interventions: Patients underwent combined intra-operative Gastroscopy and laparoscopic resection of the tumors, utilizing picture-in picture technology. Transgastric resections were performed intraluminally.
Main Outcome Measures: Tumor features (size and location), which determined surgical approach, were identified. Operative procedures performed, blood loss, and duration of hospital stay.
Results: Ten patients (M:F 7:3) with a mean age of 60.9 years (range 33-92) were identified pre-operatively by endoscopy/EUS to have submucosal gastric tumors. Tumor location/Procedure performed:
Location
Procedure
GE jxn/high lesser curve: 3
Transgastric/Laparoscopic Partial Gastrectomy
Fundus/ Upper body: 4
Laparoscopic Partial Gastrectomy
Antrum/ Distal Body: 3
Laparoscopic Distal Gastrectomy
Estimated Blood Loss was minimal (range 50-200 cc), and mean hospital stay was 3.9 days (Transgastric 2 days, Lap PG 3.6 days, Lap DG 7.3 days). A small bowel enterotomy occurred in a patient with a prior colectomy.
Median tumor size was 4.5 cm (2.5-7.0) and did not appear to influence procedure performed. Pathologic diagnoses included 7 GISTs (all c-kit + and/or CD34 +) and 3 benign tumors. All surgical margins were negative. No patient has sustained any recurrence to date.
Conclusion: Submucosal gastric tumors may be safely resected laparoscopically utilizing Intraoperative gastroscopy, with tumor location the key component of determining the approach to tumor resection.
Back to Scientific Program
Back to Annual Meeting
|
