Combined Endolaparoscopic Intragastric Excision for Gastric Neoplasms

Abstract

The aim of this study was to describe our technique of combined endolaparoscopic approach to the management of intraluminal gastric neoplasms and to review the clinical outcome. Between February 2006 and January 2008, a total of 12 patients with gastric neoplasm < or =4 cm with a mainly intraluminal component received the combined endolaparoscopic intragastric excision and were prospectively analyzed. All lesions were localized endoscopically and then treated by using a combined endoscopic submucosal dissection and laparoscopic intragastric technique. Eight of 12 lesions were gastrointestinal stromal tumours. The remaining lesions were adenomatous polyp with focal intramucosal adenocarcinoma, leiomyoma, and pancreatic heterotopia. All except 1 case was successfully treated with this technique (91.6%). There were no mortalities, and there was only 1 case of reactionary hemorrhage from the port site requiring a reoperation. The median operating time was 120 minutes, with a median blood loss of 35 mL. Length of hospital stay ranged from 3 to 12 days. There were no recurrences during the follow-up period. This combined endolaparoscopic intragastric excision technique is a truly minimally invasive alternative for selected gastric neoplasm. It is safe and feasible with a satisfactory short-term outcome.