Published online Apr 28, 2013. doi: 10.3748/wjg.v19.i16.2550
Revised: March 22, 2013
Accepted: March 28, 2013
Published online: April 28, 2013
Processing time: 239 Days and 12.1 Hours
AIM: To evaluate the feasibility and safety of a new style of laparoscopic and endoscopic cooperative surgery (LECS), an improved method of laparoscopic intragastric surgery (LIGS) for the treatment of gastric stromal tumors (GSTs).
METHODS: Six patients were treated with the new-style LECS. Surgery was performed according to the following procedures: (1) Exposing and confirming the location of the tumor with gastroscopy; (2) A laparoscopy light was placed in the cavity using the trocar at the navel, and the other two trocars penetrated both the abdominal and stomach walls; (3) With gastroscopy monitoring, the operation was carried out in the gastric lumen using laparoscopic instruments and the tumor was resected; and (4) The tumor tissue was removed orally using a gastroscopy basket, and puncture holes and perforations were sutured using titanium clips.
RESULTS: Tumor size ranged from 2.0 to 4.5 cm (average 3.50 ± 0.84 cm). The operative time ranged from 60 to 130 min (average 83.33 ± 26.58 min). Blood loss was less than 20 mL and hospital stay ranged from 6 to 8 d (average 6.67 ± 0.82 d). The patients were allowed out of bed 12 h later. A stomach tube was inserted for 72 h after surgery, and a liquid diet was then taken. All cases had single tumors which were completely resected using the new-style LECS. No postoperative complications occurred. Pathology of all resected specimens showed GST: no cases of implantation or metastasis were found.
CONCLUSION: New-style LECS for GSTs is a quick, optimized, fast recovery, safe and effective therapy.
Core tip: A new style of laparoscopic and endoscopic cooperative surgery (LECS) was used to treat gastric stromal tumors (GSTs) originating from the muscularis propria in this study. The operation was carried out in the gastric cavity, and the GST was completely removed using a gastroscopic light source and laparoscopic instruments. This method is minimally invasive and avoids many complications such as bleeding and intra-abdominal infection. Furthermore, the integrity of stomach structure and function is preserved. New-style LECS is a safe and effective method for the treatment of GSTs.