Yasuda Atsushi, Kimura Yutaka, Shiraishi Osamu, Shinkai Masayuki, Imano Motohiro, Yasuda Takushi
Department of Surgery, Kindai University Faculty of Medicine, 377-2 Ohno-higashi, Osaka-Sayama, Osaka 589-8511, Japan.
Kindai Nara Hospital, 1248-1 Otoda-cho, Ikoma, Nara 630-0293, Japan.
Int J Surg Case Rep. 2023 May;106:108156. doi: 10.1016/j.ijscr.2023.108156. Epub 2023 Apr 11.
Laparoscopic wedge resection has been widely performed for gastric gastrointestinal stromal tumors (GISTs). However, because GISTs in the esophagogastric junction (EGJ) are prone to deformity and postoperative functional disorders, laparoscopic resection is technically very difficult and rarely reported. Herein, we report a case of a GIST in the EGJ successfully treated by laparoscopic intragastric surgery (IGS).
A 58-year-old man with a GIST, which was intragastric growth type, 2.5 cm in diameter, located in the EGJ, and confirmed by upper gastrointestinal endoscope and endoscopic ultrasound-guided fine needle aspiration biopsy. We successfully performed IGS and the patient was discharged without complications.
Using laparoscopic wedge resection by exogastric approach, it is problematic to resect a gastric SMT located at the EGJ because of the difficulty in viewing the surgical field and additional concerns of deformation of the EGJ. We suppose IGS as a suitable method for such tumors.
Laparoscopic IGS for gastric GIST was useful in terms of safety and convenience even though the tumor was in the ECJ.
腹腔镜楔形切除术已广泛应用于胃胃肠道间质瘤(GIST)的治疗。然而,由于食管胃交界部(EGJ)的GIST易于变形且术后易出现功能障碍,腹腔镜切除术在技术上非常困难,鲜有报道。在此,我们报告一例通过腹腔镜胃内手术(IGS)成功治疗的EGJ部GIST病例。
一名58岁男性患有GIST,为胃内生长型,直径2.5厘米,位于EGJ,经上消化道内镜及超声内镜引导下细针穿刺活检确诊。我们成功实施了IGS,患者术后无并发症出院。
采用经胃外途径的腹腔镜楔形切除术,由于手术视野观察困难以及对EGJ变形的额外担忧,切除位于EGJ的胃黏膜下肿瘤存在问题。我们认为IGS是治疗此类肿瘤的合适方法。
对于胃GIST,即使肿瘤位于EGJ,腹腔镜IGS在安全性和便利性方面也很有用。