Laparoscopy‑assisted endoscopic full‑thickness resection of upper gastrointestinal subepithelial tumors: A single‑center early experience
- Prasit Mahawongkajit
- Pakkavuth Chanswangphuvana
Affiliations: Department of Surgery, Faculty of Medicine, Thammasat University, Pathumthani 12120, Thailand
- Published online on: March 5, 2020 https://doi.org/10.3892/mco.2020.2011
Copyright: © Mahawongkajit
et al. This is an open access article distributed under the
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Commons Attribution License.
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Recently, there have been important developments in minimally invasive full‑thickness resection of subepithelial tumors (SETs) of the upper gastrointestinal tract. However, there remain challenges with techniques such as laparoscopy‑endoscopy cooperative surgery (LECS) and non‑exposed endoscopic wall‑inversion surgery (NEWS). The aim of the present study was to further investigate the feasibility, efficacy and safety of laparoscopy‑assisted endoscopic full‑thickness resection (ETFR) of SETs and to evaluate the clinical outcomes. This retrospective study included 16 patients with upper gastrointestinal SETs who underwent laparoscopy‑assisted EFTR between July 2016 and December 2017. The patient characteristics, surgical outcomes, postoperative course, results of the histopathological examination and short‑term outcomes were reviewed and analyzed. A total of 10 patients in the LECS group and 6 patients in the NEWS group presented with SETs in the stomach (15 cases) or duodenum (1 case). The mean tumor size in the LECS group (5.6 cm) was larger compared with that in the NEWS group (2.1 cm). R0 resection was achieved in all patients, without adverse events or tumor recurrence. The NEWS group exhibited a lower white blood cell count and C‑reactive protein level on the first postoperative day, reflecting the less prominent inflammatory response, less bleeding and shorter hospitalization. Therefore, laparoscopy‑assisted EFTR by LECS and NEWS is a feasible and safe minimally invasive treatment option for upper gastrointestinal SETs in selected patients.