Ridwelski K, Pross M, Schubert S, Wolff S, Günther T, Kahl S, Lippert H
Department of Surgery, Otto von Guericke University, Leipziger Strasse 44, D-39120 Magdeburg, Germany.
Surg Endosc. 2002 Mar;16(3):537. doi: 10.1007/s004640042014. Epub 2002 Jan 9.
Gastric stromal tumors are solitary, usually asymptomatic, lesions that can bleed, become obstructive, or even degenerate into malignant neoplasms. Therefore, their surgical excision is recommended. We report a technique for the successful resection of a stromal tumor of the posterior gastric wall using a transgastric approach. After the creation of a 12 mmHg pneumoperitoneum using a three-trocar technique, a 2-cm gastrostomy was performed; an 18-mm trocar was then positioned in the gastric lumen and secured with a pursestring suture. Next, an intragastric wedge resection of the posterior gastric wall was carried out under endoscopic guidance. Finally, the anterior gastric wall was closed using a linear stapler. Histopathological analysis showed a benign spindle cell tumor, which was excised in toto. Patient recovery was uneventful. This report supports previous data showing the feasibility of a laparoscopic transgastric approach for the resection of stromal tumors of the posterior gastric wall. It also underscores the synergy of laparoscopic and endoscopic procedures in minimally invasive gastric surgery.
胃间质瘤是孤立性病变，通常无症状，可发生出血、梗阻，甚至恶变为恶性肿瘤。因此，建议对其进行手术切除。我们报告了一种通过经胃途径成功切除胃后壁间质瘤的技术。使用三套管技术建立12 mmHg气腹后，进行了2 cm的胃造口术；然后将一个18 mm的套管针置于胃腔内，并用荷包缝合固定。接下来，在内镜引导下对胃后壁进行胃内楔形切除术。最后，使用直线缝合器关闭胃前壁。组织病理学分析显示为良性梭形细胞瘤，已完整切除。患者恢复顺利。本报告支持先前的数据，表明腹腔镜经胃途径切除胃后壁间质瘤是可行的。它还强调了腹腔镜和内镜手术在微创胃手术中的协同作用。
