title: Fundic rotation technique: a useful procedure for laparoscopic exogastric resection of gastric submucosal tumors located on the posterior wall near the esophagogastric junction.
abstract: OBJECTIVE
  To develope a new procedure for laparoscopic exogastric resection using a so-called "fundic rotation technique (FRT)" for gastric submucosal tumors (SMTs) on the posterior wall near the esophagogastric junction (EGJ).
  
  
  METHODS
  Between April 2006 and February 2010, we performed laparoscopic resection for SMTs located near the EGJ (within 3.0 cm from the EGJ) in ten consecutive patients. Out of seven exogastric resections, an FRT was used in five patients with posterior tumors near the EGJ.
  
  
  RESULTS
  The patients comprised three men and two women, with an average age of 65 years. The maximum tumor diameter averaged 3.8 cm (range, 2.0-8.0 cm), and the average distance from the EGJ was 1.5 cm (range, 0-2.5 cm). The pathological diagnosis was GIST in all cases. One case was converted to an open surgery due to its large size (8.0 cm) and the difficult access. All the patients quickly returned to their normal activities. No patient complained any symptoms of regurgitation, and endoscopic examination revealed no remarkable reflux esophagitis. No tumor recurrences occurred during a median follow-up period of 30 months.
  
  
  CONCLUSIONS
  The indications for laparoscopic resection of SMTs located near the EGJ may be extended using an FRT.
authors.affiliation: Department of Surgery, Tokai University School of Medicine, Japan. h.matsui@kt-clinic.jp
authors.forename: Hideo
authors.initials: H
authors.lastname: Matsui
authors.forename: Kazuhito
authors.initials: K
authors.lastname: Nabeshima
authors.forename: Yuichi
authors.initials: Y
authors.lastname: Okamoto
authors.forename: Kenji
authors.initials: K
authors.lastname: Nakamura
authors.forename: Yasumasa
authors.initials: Y
authors.lastname: Kondoh
authors.forename: Hiroyasu
authors.initials: H
authors.lastname: Makuuchi
authors.forename: Kyoji
authors.initials: K
authors.lastname: Ogoshi
mesh_terms: D000368:Aged; D013505:Digestive System Surgical Procedures / Q000379:methods*; D004943:Esophagogastric Junction; D005260:Female; D005500:Follow-Up Studies; D005748:Gastric Fundus / Q000601:surgery*; D005770:Gastrointestinal Neoplasms / Q000473:pathology / Q000601:surgery*; D046152:Gastrointestinal Stromal Tumors / Q000473:pathology / Q000601:surgery*; D006801:Humans; D010535:Laparoscopy / Q000379:methods*; D008297:Male; D008875:Middle Aged; D016896:Treatment Outcome