Therapeutics Advances
Copyright ©The Author(s) 2015. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastrointest Endosc. Nov 10, 2015; 7(16): 1208-1215
Published online Nov 10, 2015. doi: 10.4253/wjge.v7.i16.1208
Cutting edge of endoscopic full-thickness resection for gastric tumor
Tadateru Maehata, Osamu Goto, Hiroya Takeuchi, Yuko Kitagawa, Naohisa Yahagi
Tadateru Maehata, Osamu Goto, Naohisa Yahagi, Division of Research and Development for Minimally Invasive Treatment, Cancer Center, Keio University, School of Medicine, Tokyo 160-8582, Japan
Hiroya Takeuchi, Yuko Kitagawa, Department of Surgery, Keio University, School of Medicine, Tokyo 160-8582, Japan
Author contributions: Maehata T wrote this article; Takeuchi H, Kitagawa Y and Yahagi N provided advice for this article; Goto O critically revised this article.
Conflict-of-interest statement: There is no conflict of interest regarding this article.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Osamu Goto, MD, PhD, Division of Research and Development for Minimally Invasive Treatment, Cancer Center, Keio University, School of Medicine, 35, Shinanomachi, Shinjuku-ku, Tokyo 160-8582, Japan. ogotou-gi@keio.jp
Telephone: +81-3-53633437 Fax: +81-3-53633895
Received: May 2, 2015
Peer-review started: May 9, 2015
First decision: July 17, 2015
Revised: August 18, 2015
Accepted: September 29, 2015
Article in press: September 30, 2015
Published online: November 10, 2015
Processing time: 193 Days and 12 Hours
Abstract

Recently, several studies have reported local full-thickness resection techniques using flexible endoscopy for gastric tumors, such as gastrointestinal stromal tumors, gastric carcinoid tumors, and early gastric cancer (EGC). These techniques have the advantage of allowing precise resection lines to be determined using intraluminal endoscopy. Thus, it is possible to minimize the resection area and subsequent deformity. Some of these methods include: (1) classical laparoscopic and endoscopic cooperative surgery (LECS); (2) inverted LECS; (3) combination of laparoscopic and endoscopic approaches to neoplasia with non-exposure technique; and (4) non-exposed endoscopic wall-inversion surgery. Furthermore, a recent prospective multicenter trial of the sentinel node navigation surgery (SNNS) for EGC has shown acceptable results in terms of sentinel node detection rate and the accuracy of nodal metastasis. Endoscopic full-thickness resection with SNNS is expected to become a treatment option that bridges the gap between endoscopic submucosal dissection and standard surgery for EGC. In the future, the indications for these procedures for gastric tumors could be expanded.

Keywords: Gastrointestinal stromal tumor; Early gastric cancer; Full-thickness resection; Laparoscopic and endoscopic cooperative surgery; Sentinel node navigation surgery

Core tip: Several studies have investigated local full-thickness resection techniques using flexible endoscopy for gastric tumors. These techniques are advantageous because a resection line can be determined more precisely using intraluminal endoscopy. Thus, it is possible to minimize the resection area and subsequent deformity, and better secure the surgical margins. In the near future, endoscopic full-thickness resection is expected to become a treatment option that bridges the gap between endoscopic submucosal dissection and standard surgery for gastric tumors.