Abstract
BackgroundLaparoscopic and endoscopic cooperative surgery (LECS) is a minimally invasive surgical technique used to resect gastric submucosal tumors with intraluminal growth. Endoscopic submucosal dissection is used to determine the appropriate resection line from within the stomach lumen as it minimizes the stomach wall resection area and prevents postoperative stomach deformity. Although LECS is intended to preserve gastric function, few reports have evaluated postoperative residual gastric motility. Therefore, we conducted a retrospective analysis of patients who underwent LECS to determine the effects of LECS on residual gastric motility.MethodsTwenty-two patients underwent endoscopy 3 to 12 months after LECS. Patients were evaluated for endoscopic evidence of gastric motility disorder, namely food residue and occurrence/exacerbation of reflux esophagitis. We considered patients with new onset of gastric symptoms and endoscopic evidence of gastric motility disorder to have clinically relevant gastric motility disorder. We described patient characteristics, tumor location, and surgical findings.ResultsTwo of 22 patients developed clinically relevant gastric motility disorder after LECS. In one of these patients, the symptoms were not severe; only one had reduced dietary intake and had lost weight. We identified clinically relevant gastric motility disorder in two patients with gastrointestinal stromal tumors located in the lesser curvature of the stomach. The major axis of these two tumors was 34 mm and 38 mm.ConclusionsMany patients did not have clinically relevant gastric motility disorder after LECS. Further investigation is required to identify predisposing factors for gastric motility disorder.
Highlights
Surgeons are increasingly using the minimally invasive surgical technique of laparoscopic local resection of the stomach for gastric submucosal tumors (SMTs) and early gastric cancer [1], [2], [3]
Simple wedge resection of SMTs with intraluminal growth may result in excessive gastric mucosal resection, leading to postoperative gastric deformity
For SMTs with intraluminal growth and early gastric cancer, Ohgami et al developed a technique of laparoscopic wedge resection using a lesion-lifting method [5]
Summary
Surgeons are increasingly using the minimally invasive surgical technique of laparoscopic local resection of the stomach for gastric submucosal tumors (SMTs) and early gastric cancer [1], [2], [3]. For SMTs with intraluminal growth and early gastric cancer, Ohgami et al developed a technique of laparoscopic wedge resection using a lesion-lifting method [5]. Their method requires resection of a smaller area than does the simple wedge resection technique, because the resection line is not determined from within the gastric lumen, it is difficult to minimize the resected area. Laparoscopic and endoscopic cooperative surgery (LECS) is a minimally invasive surgical technique used to resect gastric submucosal tumors with intraluminal growth. Endoscopic submucosal dissection is used to determine the appropriate resection line from within the stomach lumen as it minimizes the stomach wall resection area and prevents postoperative stomach deformity. We conducted a retrospective analysis of patients who underwent LECS to determine the effects of LECS on residual gastric motility
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