Case Report
Copyright ©The Author(s) 2023. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastrointest Surg. Jun 27, 2023; 15(6): 1216-1223
Published online Jun 27, 2023. doi: 10.4240/wjgs.v15.i6.1216
Optimal resection of gastric bronchogenic cysts based on anatomical continuity with adherent gastric muscular layer: A case report
Masayoshi Terayama, Koshi Kumagai, Hiroshi Kawachi, Rie Makuuchi, Masaru Hayami, Satoshi Ida, Manabu Ohashi, Takeshi Sano, Souya Nunobe
Masayoshi Terayama, Koshi Kumagai, Rie Makuuchi, Masaru Hayami, Satoshi Ida, Manabu Ohashi, Takeshi Sano, Souya Nunobe, Department of Gastroenterological Surgery, Gastroenterological Center, Cancer Institute Hospital, Japanese Foundation for Cancer Research, Tokyo 135-8550, Japan
Hiroshi Kawachi, Department of Pathology, Cancer Institute Hospital, Japanese Foundation for Cancer Research, Tokyo 135-8550, Japan
Author contributions: Terayama M, Kumagai K and Kawachi H contributed to manuscript writing and editing, and data collection; Nunobe S contributed to conceptualization and supervision; all authors have read and approved the final manuscript.
Informed consent statement: Informed written consent was obtained from the patient for publication of this report and any accompanying images.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (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: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Souya Nunobe, Doctor, Chief Doctor, Department of Gastroenterological Surgery, Gastroenterological Center, Cancer Institute Hospital, Japanese Foundation for Cancer Research, 3-8-31 Ariake, Koto-ku, Tokyo 135-8550, Japan. souya.nunobe@jfcr.or.jp
Received: December 22, 2022
Peer-review started: December 22, 2022
First decision: January 3, 2023
Revised: January 14, 2023
Accepted: April 19, 2023
Article in press: April 19, 2023
Published online: June 27, 2023
Processing time: 175 Days and 11.6 Hours
Abstract
BACKGROUND

Bronchogenic cysts are congenital lesions requiring radical resection because of malignant potential. However, a method for the optimal resection of these cysts has not been completely elucidated.

CASE SUMMARY

Herein, we presented three patients with bronchogenic cysts that were located adjacent to the gastric wall and resected laparoscopically. The cysts were detected incidentally with no symptoms and the preoperative diagnosis was challenging to obtain via radiological examinations. Based on laparoscopic findings, the cyst was attached firmly to the gastric wall and the boundary between the gastric and cyst walls was difficult to identify. Consequently, resection of cysts alone caused cystic wall injury in Patient 1. Meanwhile, the cyst was resected completely along with a part of the gastric wall in Patient 2. Histopathological examination revealed the final diagnosis of bronchogenic cyst and revealed that the cyst wall shared the muscular layer with the gastric wall in Patients 1 and 2. In Patient 3, the cyst was located adjacent to the gastric wall but histopathologically originated from diaphragm rather than stomach. All the patients were free from recurrence.

CONCLUSION

The findings of this study state that a safe and complete resection of bronchogenic cysts required the adherent gastric muscular layer or full-thickness dissection, if bronchogenic cysts are suspected via pre- and/or intraoperative findings.

Keywords: Bronchogenic cysts, Laparoscopic resection, Gastric wall, Muscular layer, Case report

Core Tip: Bronchogenic cysts are rare congenital lesions, which require radical resection as they might turn malignant. We presented three patients with bronchogenic cysts that were located adjacent to the gastric wall and resected laparoscopically. Based on the findings, we hypothesized that it was advisable to proceed to the stomach wall to remove the cyst completely, preventing rupture of it. This was supported by histopathological assessment which revealed bronchogenic cysts of the stomach generally shared the muscular layer with the gastric wall. Resection of cysts with the adherent gastric muscular layer or full-thickness dissection should be considered for a safe and complete resection.