title: Successful application of laparoscopic and endoscopic cooperative surgery (LECS) for a lateral-spreading mucosal gastric cancer.
abstract: In the current era of endoscopic submucosal dissection (ESD) for early gastric cancer, which carries a negligible risk of lymph node metastasis, local resection of the stomach remains an option for these lesions. This is particularly so for a large intramucosal lesion or a lesion with a strong ulcer scar, for which ESD becomes a difficult option. Here, we describe a case of lateral-spreading intramucosal gastric cancer of 6-cm diameter located at the fornix of the stomach, which was successfully treated by laparoscopic and endoscopic cooperative surgery (LECS) because of the expected risk of complications during ESD. In the LECS procedure, the resection margin was appropriately determined by the endoscopic evaluation in detail and by the ESD technique. If early gastric cancer fits the criteria for endoscopic resection but would present difficulty if performing ESD, this is a good indication for the LECS procedure.
authors.affiliation: Department of Gastroenterological Surgery, Cancer Institute Ariake Hospital, 3-8-31, Ariake, Koto-ku, Tokyo, 135-8550, Japan.
authors.forename: Souya
authors.initials: S
authors.lastname: Nunobe
authors.forename: Naoki
authors.initials: N
authors.lastname: Hiki
authors.forename: Takuji
authors.initials: T
authors.lastname: Gotoda
authors.forename: Takahisa
authors.initials: T
authors.lastname: Murao
authors.forename: Ken
authors.initials: K
authors.lastname: Haruma
authors.forename: Hideo
authors.initials: H
authors.lastname: Matsumoto
authors.forename: Toshihiro
authors.initials: T
authors.lastname: Hirai
authors.forename: Shinya
authors.initials: S
authors.lastname: Tanimura
authors.forename: Takeshi
authors.initials: T
authors.lastname: Sano
authors.forename: Toshiharu
authors.initials: T
authors.lastname: Yamaguchi
mesh_terms: D000368:Aged; D005260:Female; D005753:Gastric Mucosa / Q000473:pathology; D005773:Gastroscopy / Q000379:methods*; D006801:Humans; D010535:Laparoscopy / Q000379:methods*; D013274:Stomach Neoplasms / Q000473:pathology* / Q000601:surgery*