Mikito Mori
Teikyo University Chiba Medical Center, Japan
Title: Successful application of laparoscopic and endoscopic cooperative surgery for gastrointestinal stromal tumor with anatomical complexity: Report of two cases
Biography
Biography: Mikito Mori
Abstract
Local resection is the standard treatment for gastrointestinal stromal tumors (GISTs), and laparoscopic and endoscopic cooperative surgery (LECS) is considered to be a safe and useful procedure because it not only enables dissection of a tumor with minimal extra gastrointestinal wall tissue, but is also suitable for all tumor locations, including duodenal lesion and proximity to the esophagogastric junction or pyloric ring. We herein report our experience of performing LECS for two patients with GIST. Case 1: A 78-year-old man was referred to our department for treatment of a gastric sub-mucosal tumor. Based on chest X-ray and computed tomography (CT) findings, complete situs inversus was also diagnosed. Upper gastrointestinal endoscopy and imaging showed a 45 mm gastric sub-mucosal tumor in the upper stomach near the esophagogastric junction. We performed local resection of the GIST by LECS. Pathological examination revealed that the tumor was an intermediate-risk GIST and the patient was discharged on postoperative day 12. Case 2: A 60-year-old man was referred to our department for treatment of a duodenal sub-mucosal tumor. Upper gastrointestinal endoscopy and imaging showed a 25 mm duodenal sub-mucosal tumor in the posterior wall of the first portion of the duodenum. We performed local resection of the duodenal sub-mucosal tumor by LECS. Pathological examination revealed that the tumor was a low-risk GIST and the patient was discharged on postoperative day 12. LECS can be performed even in patients with anatomical complexity provided the anatomy and vascularization are carefully assessed preoperatively by diagnostic imaging
