Intragastric Single-Incision Laparoscopic Surgery for Gastric Leiomyoma: A Stepwise Approach.

Ann Surg Oncol

Service de chirurgie viscérale et oncologique, Hospices Civils de Lyon, Hôpital Lyon Sud, Lyon, France.

Published: August 2017

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http://dx.doi.org/10.1245/s10434-017-5868-5DOI Listing

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  • This report presents the first known case of percutaneous endoscopic intragastric surgery (PEIGS) being used to treat gastric metastases from renal cell carcinoma (RCC) in a 70-year-old male.
  • The patient underwent a partial gastrectomy with single-incision PEIGS, and two years later, a follow-up revealed a new tumor, which was also metastatic RCC, leading to a repeat of the surgery.
  • After the second surgery, there were no signs of cancer recurrence, highlighting that PEIGS is a promising minimally invasive option for treating metastatic gastric tumors.
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Recent reports have described the practicality of laparoscopic intragastric surgery (l-IGS) as an alternative for resecting submucosal tumors (SMTs) near the esophagogastric junction (EGJ), where excision using an exogastric approach would be difficult. However, even using IGS to perform a full-thickness resection of SMTs that are in or extremely close to the EGJ is very difficult to do safely and avoid disrupting or causing stenosis of the EGJ, without advanced experience. This study retrospectively examined the usefulness of l-IGS for gastric SMTs located in or extremely close to the EGJ.

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Laparoscopic local resection of the stomach for gastric submucosal tumors (SMTs) is widely accepted by surgeons. For SMTs located near the esophagogastric junction (EGJ), simple laparoscopic wedge resection is rarely performed owing to concerns of causing cardia deformities or stenosis. Single-incision laparoscopic intragastric surgery (sLIGS) has been used to treat SMTs located near the EGJ in carefully selected cases.

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