Laparoscopic intragastric surgery revisited:  its role for submucosal tumors adjacent to the esophagogastric junction.
OBJECTIVE
When the gastric submucosal tumor (SMT) locates adjacent to the esophagogastric junction (EGJ), it is difficult to preserve EGJ technically and oncologically. In this study, we describe our clinical experience with laparoscopic intragastric surgery (LIGS) and discuss its role for gastric SMTs adjacent to EGJ.


METHODS
A retrospective review was performed on patients who underwent surgical treatment of gastric SMTs adjacent to EGJ (April 1994 to May 2010). They were divided into 3 groups: laparoscopic partial gastrectomy (LAP, n=10), LIGS (n=10), and open laparotomy (OPEN, n=7), respectively.


RESULTS
The completion rates were 50% in LAP and 90% in LIGS. Overall preservation rate of EGJ was 80% (LAP), 100% (LIGS), and 29% (OPEN), respectively. The patients who underwent total/proximal mastectomy showed significantly higher incidence of postoperative gastrointestinal symptoms, which required long-term medication.


CONCLUSIONS
LIGS stays as a valuable alternative and would be an attractive option for gastric SMTs adjacent to EGJ.
Department of Surgery, Osaka University Graduate School of Medicine, Osaka, Japan.
Johji
J
Hara
Kiyokazu
K
Nakajima
Tsuyoshi
T
Takahashi
Makoto
M
Yamasaki
Hiroshi
H
Miyata
Yukinori
Y
Kurokawa
Shuji
S
Takiguchi
Masaki
M
Mori
Yuichiro
Y
Doki
D000328:Adult; D000368:Aged; D016063:Blood Loss, Surgical; D004943:Esophagogastric Junction / Q000601:surgery*; D005260:Female; D005743:Gastrectomy / Q000379:methods*; D005753:Gastric Mucosa / Q000601:surgery; D006801:Humans; D010535:Laparoscopy / Q000379:methods*; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D059351:Organ Sparing Treatments / Q000379:methods; D011183:Postoperative Complications / Q000209:etiology; D011446:Prospective Studies; D012189:Retrospective Studies; D013274:Stomach Neoplasms / Q000601:surgery*; D016896:Treatment Outcome