Wang Junjiang, Yang Zifeng, Zheng Jiabin, Hu Weixian, Feng Xingyu, Yao Xueqing, Li Yong
1 Guangdong General Hospital , Guangdong Academy of Medical Sciences, Guangzhou, China .
2 The Second School of Clinical Medicine, Southern Medical University , Guangzhou, China .
J Laparoendosc Adv Surg Tech A. 2019 Mar;29(3):374-378. doi: 10.1089/lap.2018.0334. Epub 2018 Oct 5.
Total-laparoscopic intragastric surgery (T-LIGS) has gradually been accepted for the treatment of endogenous gastric submucosal tumors. However, it is difficult to perform T-LIGS when the tumor is located at the esophagogastric junction (cardia endogenous gastric submucosal tumor [CEGSMT]) without special laparoscopic instruments that are not available in most developing countries. We have successfully treated 12 cases of CEGSMTs using conventional laparoscopic instruments and achieved acceptable outcomes. This study was conducted to evaluate the surgical techniques for CEGSMT management.
A retrospective analysis was conducted involving all the CEGSMT patients who were treated with T-LIGS in the General Surgery Department of Guangdong General Hospital from August 2014 to June 2016.
There were 12 patients successfully treated with T-LIGS. The surgical time ranged from 56 to 108 minutes, and the blood loss was 5-70 mL. The distance to the tumor from the dentate line was 12-24 mm, and the tumor diameter was 17-28 mm. The tumor margins were 9-15 mm, and the eating time was 2-4 days. The drainage tube indwelling time was 2-4 days, and the discharge time was 4-6 days. The follow-up exams revealed no recurrences, dysphagia, acid reflux, or other digestive symptoms.
It is safe and feasible to perform T-LIGS using conventional laparoscopic instruments to treat CEGSMTs. We suggest that T-LIGS can be performed for endogenous mucosal tumors within 3 cm from the cardiac dentate line and less than 3 cm in size.
全腹腔镜胃内手术（T-LIGS）已逐渐被用于治疗胃内源性黏膜下肿瘤。然而，当肿瘤位于食管胃交界部（贲门胃内源性黏膜下肿瘤[CEGSMT]）时，若没有大多数发展中国家所没有的特殊腹腔镜器械，很难进行T-LIGS。我们使用传统腹腔镜器械成功治疗了12例CEGSMT患者，并取得了可接受的结果。本研究旨在评估CEGSMT治疗的手术技术。
对2014年8月至2016年6月在广东省人民医院普通外科接受T-LIGS治疗的所有CEGSMT患者进行回顾性分析。
12例患者成功接受T-LIGS治疗。手术时间为56至108分钟，出血量为5至70毫升。肿瘤距齿状线的距离为12至24毫米，肿瘤直径为17至28毫米。肿瘤切缘为9至15毫米，进食时间为2至4天。引流管留置时间为2至4天，出院时间为4至6天。随访检查未发现复发、吞咽困难、反酸或其他消化症状。
使用传统腹腔镜器械进行T-LIGS治疗CEGSMT是安全可行的。我们建议，对于距贲门齿状线3厘米以内、大小小于3厘米的内源性黏膜肿瘤可进行T-LIGS。
