Endoscopic trans gastric assisted surgery for gastric tumors: Case report and description of a new surgical technique.
Endoscopy
Gastric
Gastric tumors
Sub epithelial gastric lesion
Surgery
Journal
International journal of surgery case reports
ISSN: 2210-2612
Titre abrégé: Int J Surg Case Rep
Pays: Netherlands
ID NLM: 101529872
Informations de publication
Date de publication:
2020
2020
Historique:
received:
12
10
2019
revised:
15
11
2019
accepted:
25
11
2019
pubmed:
18
12
2019
medline:
18
12
2019
entrez:
18
12
2019
Statut:
ppublish
Résumé
Minimally invasive intragastric surgery [IGS] was first described by Ohashi in 1995 for early gastric cancer, with 3 trocars placed in the gastric lumen. Prior abdominal surgery is not a contraindication to IGS while the abdominal cavity is not explored, always that exist transilumination. But conversion to laparoscopic and open surgery can be challenging owing to the insufflated stomach and/or small bowel, although gas can be easily released via the gastrostomy. A 53-year-old female patient, presented with a sub epithelial gastric antrum lesion confirmed by endoscopic ultrasonography managed with surgical endoscopic percutaneous assisted transgastric technique [EPATS] using a gastrostomy tube and the endoscope. We have been developing this operation since 2018. Nevertheless, we think EPATS is worthy to master, as PEIGS can salvage the entire stomach of patients with sub epithelial lesions in the lesser curve and in the esophagogastric junction, who otherwise would have to undergo total or proximal gastrectomy. We need to perform more cases for future comparative studies with percutaneous endoscopic intragastric surgery [PEIGS] in terms of parameters as pain, inflammation, complications, stenosis, oncological results and cosmesis.
Sections du résumé
BACKGROUND
BACKGROUND
Minimally invasive intragastric surgery [IGS] was first described by Ohashi in 1995 for early gastric cancer, with 3 trocars placed in the gastric lumen. Prior abdominal surgery is not a contraindication to IGS while the abdominal cavity is not explored, always that exist transilumination. But conversion to laparoscopic and open surgery can be challenging owing to the insufflated stomach and/or small bowel, although gas can be easily released via the gastrostomy.
CASE PRESENTATION
METHODS
A 53-year-old female patient, presented with a sub epithelial gastric antrum lesion confirmed by endoscopic ultrasonography managed with surgical endoscopic percutaneous assisted transgastric technique [EPATS] using a gastrostomy tube and the endoscope.
DISCUSSION
CONCLUSIONS
We have been developing this operation since 2018. Nevertheless, we think EPATS is worthy to master, as PEIGS can salvage the entire stomach of patients with sub epithelial lesions in the lesser curve and in the esophagogastric junction, who otherwise would have to undergo total or proximal gastrectomy.
CONCLUSION
CONCLUSIONS
We need to perform more cases for future comparative studies with percutaneous endoscopic intragastric surgery [PEIGS] in terms of parameters as pain, inflammation, complications, stenosis, oncological results and cosmesis.
Identifiants
pubmed: 31846868
pii: S2210-2612(19)30683-2
doi: 10.1016/j.ijscr.2019.11.049
pmc: PMC6920225
pii:
doi:
Types de publication
Case Reports
Langues
eng
Pagination
153-157Subventions
Organisme : NCI NIH HHS
ID : P30 CA008748
Pays : United States
Informations de copyright
Copyright © 2019 The Authors. Published by Elsevier Ltd.. All rights reserved.
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