title: Combined endoscopic intragastral resection of a posterior stromal gastric tumor using an original technique.
abstract: Gastric stromal tumors are solitary, usually asymptomatic, lesions that can bleed, become obstructive, or even degenerate into malignant neoplasms. Therefore, their surgical excision is recommended. We report a technique for the successful resection of a stromal tumor of the posterior gastric wall using a transgastric approach. After the creation of a 12 mmHg pneumoperitoneum using a three-trocar technique, a 2-cm gastrostomy was performed; an 18-mm trocar was then positioned in the gastric lumen and secured with a pursestring suture. Next, an intragastric wedge resection of the posterior gastric wall was carried out under endoscopic guidance. Finally, the anterior gastric wall was closed using a linear stapler. Histopathological analysis showed a benign spindle cell tumor, which was excised in toto. Patient recovery was uneventful. This report supports previous data showing the feasibility of a laparoscopic transgastric approach for the resection of stromal tumors of the posterior gastric wall. It also underscores the synergy of laparoscopic and endoscopic procedures in minimally invasive gastric surgery.
authors.affiliation: Department of Surgery, Otto von Guericke University, Leipziger Strasse 44, D-39120 Magdeburg, Germany. karsten.ridwelski@medizin.uni-magdeburg.de
authors.forename: K
authors.initials: K
authors.lastname: Ridwelski
authors.forename: M
authors.initials: M
authors.lastname: Pross
authors.forename: S
authors.initials: S
authors.lastname: Schubert
authors.forename: S
authors.initials: S
authors.lastname: Wolff
authors.forename: T
authors.initials: T
authors.lastname: Günther
authors.forename: S
authors.initials: S
authors.lastname: Kahl
authors.forename: H
authors.initials: H
authors.lastname: Lippert
mesh_terms: D000368:Aged; D002277:Carcinoma / Q000601:surgery*; D005240:Feasibility Studies; D005773:Gastroscopy / Q000379:methods*; D005774:Gastrostomy / Q000379:methods; D006801:Humans; D010535:Laparoscopy / Q000379:methods*; D008297:Male; D013274:Stomach Neoplasms / Q000601:surgery*; D013536:Suture Techniques