title: Surgical advantages of gastric SMTs by laparoscopy and endoscopy cooperative surgery.
abstract: OBJECTIVE
  The treatment of gastric submucosal tumors (SMTs) is strictly surgical and enucleation of the tumor or wedge resection of the stomach is efficient to achieve R0 resection. Laparoscopic and endoscopic cooperative surgery (LECS) can be safely performed with adequate cutting lines. This study describes the initial 16 cases treated by LECS and evaluates the advantages by LECS for gastric SMTs retrospectively.
  
  
  METHODS
  Sixteen patients with gastric SMT underwent LECS from June 2007 to December 2010, their surgical data, clinical characteristics and surgical specimens of SMTs were compared. The surgical specimens of 9 gastric SMTs treated by laparoscopic wedge resection (LWR) were compared as a control.
  
  
  RESULTS
  The median (range) length of operation time, blood loss, hospital stay after surgery were minutes 172 (115- 220), <5mL (<5-115) and 10 days (6-17), respectively. The median (range) ratio of the longest diameter of the tumor divided by the longest diameter of the surgical specimen in LECS and LWR were 0.86 (0.625-1.0) and 0.69 (0.44-1.0), respectively (p=0.0189, Wilcoxon rank sum test).
  
  
  CONCLUSIONS
  LECS minimizes the surgical specimen while still providing sufficient surgical margins to successfully cure gastric SMTs.
authors.affiliation: Chiba University, Chiba, Japan. hk@faculty.chiba-u.jp
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Kawahira
authors.forename: Hideki
authors.initials: H
authors.lastname: Hayashi
authors.forename: Toshiyuki
authors.initials: T
authors.lastname: Natsume
authors.forename: Takashi
authors.initials: T
authors.lastname: Akai
authors.forename: Masaya
authors.initials: M
authors.lastname: Uesato
authors.forename: Daisuke
authors.initials: D
authors.lastname: Horibe
authors.forename: Mikito
authors.initials: M
authors.lastname: Mori
authors.forename: Naoyuki
authors.initials: N
authors.lastname: Hanari
authors.forename: Hiromichi
authors.initials: H
authors.lastname: Aoyama
authors.forename: Yoshihiro
authors.initials: Y
authors.lastname: Nabeya
authors.forename: Kiyohiko
authors.initials: K
authors.lastname: Shuto
authors.forename: Hisahiro
authors.initials: H
authors.lastname: Matsubara
mesh_terms: D000328:Adult; D000368:Aged; D016063:Blood Loss, Surgical; D005260:Female; D005773:Gastroscopy; D006801:Humans; D010535:Laparoscopy; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D018365:Neoplasm, Residual; D012189:Retrospective Studies; D013274:Stomach Neoplasms / Q000473:pathology / Q000601:surgery*; D013997:Time Factors; D016896:Treatment Outcome