Laparoscopic resection for submucosal tumors near the esophagogastric junction: feasibility and short-term outcome

Surg Innov. 2013 Oct;20(5):478-83. doi: 10.1177/1553350612469281. Epub 2012 Dec 5.

Abstract

Background: Minimally invasive surgery has proved to be effective and efficient in the management of gastric submucosal tumors (SMT). However, confronting a SMT near the esophagogastric junction (EGJ) is still challenging because of the potentially devastating risks of stenosis or leakage. This study evaluated the safety, feasibility, and oncological efficacy of laparoscopic resection for SMTs located near the EGJ.

Methods: From December 2008 to November 2011, we enrolled a total of 19 patients diagnosed with gastric SMTs located near the EGJ who underwent laparoscopic surgery. The clinicopathological characteristics and surgical outcomes of the 19 patients were recorded and reviewed retrospectively.

Results: All 19 patients underwent laparoscopic resections of their gastric SMTs without complications during the study period. There were 9 men and 10 women, with a mean age of 63.3 ± 15.1 years (range 33-86 years). The operative duration was 187.8 ± 58.9 minutes (range 90-310 minutes). Intraoperative localization included endoscopy (n = 3), tattooing (n = 2), and combined modalities (n = 1). The exogastric (n = 12) and transgastric methods (n = 7) were used. The histopathology showed 10 gastrointestinal stromal tumors, 7 leiomyomas, 1 hyperplastic polyp, and 1 lipoma. The postoperative courses for all cases were uneventful. The mean follow-up period was 16.7 ± 9.4 months, with no recurrence noted.

Conclusions: Laparoscopic resections for gastric SMTs near the EGJ are safe and feasible, with satisfactory oncological outcomes in the short term.

Keywords: esophagogastric Junction; laparoscopic surgery; submucosal tumor.

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Esophagogastric Junction / surgery*
  • Female
  • Gastric Mucosa / pathology
  • Gastric Mucosa / surgery
  • Humans
  • Laparoscopy / adverse effects
  • Laparoscopy / methods*
  • Male
  • Middle Aged
  • Postoperative Complications
  • Retrospective Studies
  • Stomach Neoplasms / pathology
  • Stomach Neoplasms / surgery*
  • Treatment Outcome