Is laparoscopic and endoscopic cooperative surgery (LECS) for gastric subepithelial tumor at the esophagogastric junction safe?
conversion surgery
esophagogastric junction
laparoscopic and endoscopic cooperative surgery
Journal
Asian journal of endoscopic surgery
ISSN: 1758-5910
Titre abrégé: Asian J Endosc Surg
Pays: Japan
ID NLM: 101506753
Informations de publication
Date de publication:
Apr 2021
Apr 2021
Historique:
revised:
30
06
2020
received:
15
04
2020
accepted:
12
08
2020
pubmed:
15
10
2020
medline:
20
8
2021
entrez:
14
10
2020
Statut:
ppublish
Résumé
With technique improvements, indications for laparoscopic and endoscopic cooperative surgery (LECS) for gastric subepithelial tumor (SET) are gradually expanding for tumors technically difficult to resect. However, surgical outcomes of LECS, including for esophagogastric junction (EGJ) tumors requiring advanced skills, remain unknown. We reviewed patients in whom LECS had initially been attempted for gastric SET at the Cancer Institute Hospital in Tokyo from June 2006 to May 2018. Indications for LECS at the EGJ have gradually expanded during the study period to include tumors with esophageal invasion up to 2 cm, or less than half the EJG circumference, preoperatively. Surgical outcomes and risk factors for conversion to other procedures were investigated. Twenty (9.3%) of the 214 total patients had EGJ tumors. Four patients (20%) with EGJ tumors developed postoperative complications (Clavien-Dindo grade ≥ II). Among 12 patients in whom LECS could be completed for EGJ tumors, only one non-serious complication occurred. Eight patients required conversion to another operation for EGJ tumors (two laparotomy, six proximal gastrectomy). Among conversion cases with EGJ tumors, anastomotic leakage occurred in both patients undergoing laparotomy after LECS, necessitating additional defect closure. There was only one non-serious complication in six proximal gastrectomy patients. On multivariate analysis, EGJ tumor was an independent risk factor for conversion to another operation. LECS at the EGJ may be a risk factor for conversion operation, and when performing LECS at the EGJ is difficult, conversion to proximal gastrectomy, which can be performed safely, should be considered.
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
223-231Informations de copyright
© 2020 Asia Endosurgery Task Force and Japan Society of Endoscopic Surgery and John Wiley & Sons Australia, Ltd.
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