Laparoscopic-Endoscopic Cooperative Intragastric Surgery for Gastric Tumors: A Case Report and Surgical Technique Description
Abstract
Introduction: Gastric submucosal tumors (SMT) were traditionally treated through open or laparoscopic surgery. Nevertheless, these approaches carry a higher structural and functional morbidity. Laparo-endoscopic collaborative intragastric surgery (LECS) is a minimally invasive procedure which allows a more tissue conservative gastric SMT resection, reducing patient morbidity. Several cases of SMT resections using LECS have been presented, but there is still little literature about it. This work presents LECS as an alternative for gastric tumor resections based on a surgical case.
Case report: An adult female diagnosed with a gastric subepithelial GIST was programmed for LECS tumor resection. Endoscopically the tumor was superficially dissected. Intragastric laparoscopic deeper dissection was performed and with linear cutting staplers a tumor of 31 mm was resected with negative margins. Surgical time was 58 minutes and operative minimal blood loss was obtained. The patient showed adequate post-operatory evolution since day one.
Conclusion: LECS is an alternative for gastric SMT resection since it preserves the stomach with less operation time and adverse effects. This step by step surgical technique description confirms the safety and feasibility for its performance in middle-low income countries since it offers an appropriate functional outcome as well as an uneventful postoperative course. Nevertheless, more procedures need to be performed in order to evaluate accordingly for other parameters such as pain, cosmesis and long-term complications.
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