Sekimoto M, Tamura S, Hasuike Y, Yano M, Murata A, Inoue M, Shiozaki H, Monden M
Department of Surgery II, Osaka University Medical School, 2-2 Yamadaoka Suita, Osaka 565, Japan.
Surg Endosc. 1999 Jan;13(1):71-4. doi: 10.1007/s004649900902.
Several reports have been published which describe the technique of using an Endo GIA to resect submucosal tumors on the anterior wall of the stomach. Lesions on the posterior wall, however, especially near the esophagocardiac junction (ECJ), are difficult to resect using these reported techniques. This is because the surgeon must divide the omentum and enter the omental bursa in order to use a similar extraluminal technique. Furthermore, special care must be taken to ensure that resections do not involve the ECJ and narrow the esophagus. In order to overcome these difficulties, we have proposed a new technique for the laparoscopic excision of a submucosal tumor located on the posterior wall of the gastric fundus. The principle of this procedure involves the intraluminal resection of the submucosal tumor, including the surrounding stomach wall, using the Endo GIA. This technique is safe, simple, and effective. We believe that we are the first to address the excision of a submucosal lesion by resecting the full thickness of the posterior gastric wall lesion intraluminally.
已有多篇报道描述了使用Endo GIA切除胃前壁黏膜下肿瘤的技术。然而，胃后壁的病变，尤其是靠近食管胃交界（ECJ）处的病变，采用这些报道的技术很难切除。这是因为外科医生必须分开网膜并进入网膜囊才能采用类似的腔外技术。此外，必须格外小心以确保切除不涉及ECJ且不使食管变窄。为了克服这些困难，我们提出了一种用于腹腔镜切除胃底后壁黏膜下肿瘤的新技术。该手术的原理包括使用Endo GIA在腔内切除黏膜下肿瘤，包括周围的胃壁。这项技术安全、简单且有效。我们认为我们是首个通过腔内切除胃后壁病变的全层来处理黏膜下病变切除的。
