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Short-term outcome of serosal and muscular layers incision technique in laparoscopic surgery for gastric gastrointestinal stromal tumors

Yusuke Itai, Hajime Fujishima, Tsuyoshi Etoh, Yohei Kono, Tomonori Akagi, Kosuke Suzuki, Tomotaka Shibata, Yoshitake Ueda, Manabu Tojigamori, Hidefumi Shiroshita, Norio Shiraishi, Masafumi Inomata. Oita University

Background: Laparoscopic surgery for gastric gastrointestinal stromal tumors (GISTs) has been widely adapted because of its less invasiveness. Excessive gastric resection may result in postoperative deformity of the stomach, with consequent gastric stasis in food uptake. To minimize the resection of stomach tissue, especially for lesions close to the esophagogastric junction or pyloric ring, we have developed laparoscopic wedge resection (LWR) with the serosal and muscular layers incision technique (SAMIT) for gastric gastrointestinal stromal tumors. This SAMIT is simple and does not require special devices.

Purpose: The purpose of this study was to clarify whether LWR with SAMIT for gastric GISTs is technically feasible in term of short-term outcome.

Patients and Methods: Between 2001 and 2014, 37 patients who underwent LWR for gastric GIST in Oita University were enrolled in this retrospective study. These patients were divided two groups based on LWR with SAMIT; SAMIT group (n=14) and LWR without SAMIT; non-SAMIT group (n=23). Baseline characteristics, operative results including complications and pathological results were compared between the two groups.

Results: There was no significant difference in the age, gender and tumor growth type between the two groups. For lesions located less than 2 cm from the esophagogastric junction, the frequency of SAMIT was significantly higher than that of non-SAMIT. In operative results, the mean operative time was significantly longer in the SAMIT group. Regarding to intraoperative complications, there was no event in SAMIT group. In contrast, bleeding occurred in one case in non-SAMIT group. Regarding to postoperative complications, stenosis occurred in 1 case for middle stomach lesions in SAMIT group. This stenosis could be improved by endoscopic balooning. Histological examination revealed that adequate oncological resection was performed in all cases.

Conclusions: LWR with SAMIT for gastric GISTs was feasible in terms of short-term outcome. This technique could be useful for treating gastric gastrointestinal stromal tumors, including those close to the esophagogastric junction or pyloric ring.

 


Presented at the SAGES 2017 Annual Meeting in Houston, TX.

Abstract ID: 87874

Program Number: P729

Presentation Session: iPoster Session (Non CME)

Presentation Type: Poster

7

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