Obuchi Toru, Sasaki Akira, Baba Shigeaki, Nitta Hiroyuki, Otsuka Koki, Wakabayashi Go
Department of Surgery, Iwate Medical University School of Medicine, 19-1 Uchimaru, Morioka, 020-8505, Japan,
Surg Today. 2015 May;45(5):641-6. doi: 10.1007/s00595-014-0870-z. Epub 2014 Mar 16.
We herein report a case of single-port laparoscopic and endoscopic cooperative surgery (LECS) for a gastric gastrointestinal stromal tumor (GIST). A 75-year-old female with an endoluminal GIST located near the esophagogastric junction underwent LECS. Both the mucosal and submucosal layers around the tumor were circumferentially dissected using endoscopic submucosal dissection via intraluminal endoscopy. The endoluminal GIST was exteriorized to the abdominal cavity. The tumor and the edge of the incision line were closed using an endoscopic linear stapler. The LECS was successfully accomplished without the need for any skin incisions or additional ports. The length of the operation was 120 min and blood loss was 5 ml. Oral intake was resumed on the second day and the length of hospital stay was 5 days. No complications were noted and the patient had an excellent cosmetic result. In our experience, single-port LECS is feasible and safe for gastric GIST when performed by a surgeon experienced in laparoscopic and gastric surgery.
我们在此报告一例采用单孔腹腔镜与内镜联合手术(LECS)治疗胃胃肠道间质瘤(GIST)的病例。一名75岁女性,其腔内GIST位于食管胃交界处附近,接受了LECS手术。通过腔内内镜使用内镜黏膜下剥离术对肿瘤周围的黏膜层和黏膜下层进行环形剥离。将腔内GIST翻至腹腔。使用内镜直线缝合器关闭肿瘤及切口边缘。LECS手术成功完成,无需任何皮肤切口或额外的穿刺孔。手术时长120分钟,出血量为5毫升。术后第二天恢复经口进食,住院时长为5天。未发现并发症,患者的美容效果极佳。根据我们的经验,对于有腹腔镜及胃部手术经验的外科医生而言,单孔LECS治疗胃GIST是可行且安全的。