ABSTRACT
As the diagnosis rate of early gastric cancer is increasing annually, the current hot spot in the treatment of early gastric cancer is how to better preserve the anatomical structure and physiological function of the stomach and improve the quality of life of patients after surgery under the premise of tumor eradication. Therefore, function-preserving gastrectomy has been the trend of surgical treatment for early gastric cancer. It is not just a modified gastrectomy, but a better combination of improved surgical techniques and the concept of function-preserving treatment, rather than being limited to traditional surgical treatments. Currently, the routine function-preserving gastrectomy mainly includes pylorus-preserving gastrectomy, proximal gastrectomy and partial gastrectomy combined with endoscopy. In addition, with the deeper understanding of metastasis pattern of gastric cancer and the development and popularization of minimally invasive techniques, laparoscopic and endoscopic cooperative surgery is gradually gaining attention. The application of laparoscopic and endoscopic hybrid surgery combined with sentinel lymph node navigation is anticipated in the treatment of early gastric cancer.
Subject(s)
Humans , Gastrectomy , Laparoscopy , Lymph Node Excision , Pylorus , Quality of Life , Stomach Neoplasms/surgeryABSTRACT
Objective To investigate the feasibility of laparoscopic endoscopic cooperative dissection without mucosa injury for patients with small gastric stromal tumor. Methods Fifteen patients with small gastric stromal tumor underwent laparoscopy and endoscopy combination therapy from January 2015 to October 2016. The gastric serous layer was cut open after submucosal injection, and then tumor was removed without mucosa injury under laparoscope. The clinical data were retrospectively analyzed. Results All of the 15 patients successfully completed the operation,and no one conversed to open surgery because of intraoperative complications. The operation time was 53.4±15.8 min, and the intraoperative blood loss was 15.2±3.5 mL. The gastric tube was pulled out on the day of operation.The mean time of recovering liquid diet after operation was 1.6±0.5 days, and the length of postoperative hospital stay was 3.3 ± 0.6 days. All the specimen had complete pseudocapsule,and their pathology results were all gastric stromal tumors,including 12 cases of very low risk degree, 2 low risk degree, and 1 middle risk degree. Conclusion Laparoscopic endoscopic cooperative dissection for small gastric stromal tumor has satisfactory short-term outcomes and shows a quick postoperative recovery,which meets the idea of minimally invasive surgery and rapid recovery. It is a new choice of treatment for patients with small gastric stromal tumor.