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Laparoscopic resection of gastric submucosal tumors has been described, but the role of laparoscopy for tumors within the esophagus or near the gastroesophageal junction is not clearly defined. The aim of this study was to examine the outcomes of laparoscopic or thoracoscopic enucleation or wedge resection of benign gastric tumors. The charts of 44 patients who underwent minimally invasive resection of benign esophagogastric tumors were reviewed. Surgical approaches included thoracoscopic enucleation (n = 2), laparoscopic enucleation (n = 6), transgastric enucleation (n = 2), and laparoscopic gastric wedge resection (n = 34). There were 23 males with a mean age of 57 years. There was one conversion (2.5%) to laparotomy. Mean operative time was 97 ± 52 minutes. The mean length of hospital stay was 2.6 ± 2.0 days. One patient developed gastric outlet obstruction requiring Roux-en-Y reconstruction. There were no leaks and the 90-day mortality was zero. Pathology demonstrated gastrointestinal stromal tumor (n = 31), leiomyoma (n = 6), and other benign pathology (n = 7). There has been one tumor recurrence at a mean followup of 4.3 years. The laparoscopic approaches to local resection of gastric tumors are safe and feasible. The type of minimally invasive surgical approaches should be tailored based on the location and size of the lesion.
BENIGN TUMORS of the stomach and esophagus are common consisting primarily of gastrointestinal stromal tumors derived from smooth muscle cell origin.1,2 Other submucosal tumors or benign masses arising within the stomach and esophagus include leiomyoma, ectopic pancreas, neurofibroma, and even carcinoid. Surgical resection is widely accepted as the definitive treatment for these tumors. Laparoscopic resection of a gastric submucosal tumor was first described in 1992.3 Since the first description of the laparoscopic technique, multiple published series have demonstrated the feasibility and safety of the laparoscopic wedge resection of gastric submucosal tumors.4-13 However, laparoscopic wedge resection cannot be performed when the tumor is located within the esophagus or near the gastroesophageal junction. At these locations, minimally invasive surgical technique for local resection may require enucleation or laparoscopic transgastric resection.14· 15 The aim of this study was to examine the outcomes of our experience with consecutive cases of laparoscopic or thoracoscopic enucleation or wedge resection of benign esophagogastric tumors.
Patients and Methods
Between June...