Department of Surgery, National Hospital Organization Osaka National Hospital, Osaka, Japan.
Department of Diagnostic Pathology, National Hospital Organization Osaka National Hospital, Osaka, Japan.
Asian J Endosc Surg. 2021 Oct;14(4):794-797. doi: 10.1111/ases.12927. Epub 2021 Feb 16.
Laparoscopic wedge resection (LWR) for intraluminal gastrointestinal stromal tumor (GIST) leads to excessive resection of normal gastric wall. We report a case of GIST around the cardia successfully treated with full-thickness partial resection using a hybrid approach of laparoscopic surgery and single-incision intragastric surgery (SIIGS). A 69-year-old woman had a 5 cm intraluminal GIST at the posterior wall around the cardia. Submucosal injection of glycerin and indigo carmine was performed with transoral endoscopy. Circumferential seromuscular incision followed by placement of seromuscular sutures to invert the lesion into the stomach was performed under laparoscopy. By SIIGS, resection of the inverted mucosa and retrieval of the tumor were completed. A hybrid approach consisting of laparoscopic wall-inversion surgery and SIIGS was useful for intraluminal GIST and may expand the indications for laparoscopic wall-inversion surgery by removing size limitations.
腹腔镜楔形切除术（LWR）治疗腔内胃肠道间质瘤（GIST）会导致正常胃壁过度切除。我们报告了一例贲门周围 GIST 成功采用腹腔镜手术和单孔经胃手术（SIIGS）联合的全层部分切除术治疗的病例。一名 69 岁女性在贲门后壁有一个 5cm 的腔内 GIST。经口内镜下进行黏膜下注射甘油和靛胭脂。腹腔镜下进行环肌层切开，然后放置肌层缝线将病变翻转到胃内。通过 SIIGS 完成翻转黏膜的切除和肿瘤的取出。由腹腔镜壁内翻术和 SIIGS 组成的杂交方法对腔内 GIST 有效，并且可以通过消除大小限制来扩大腹腔镜壁内翻术的适应证。
