title: New-style laparoscopic and endoscopic cooperative surgery for gastric stromal tumors.
abstract: OBJECTIVE
  To evaluate the feasibility and safety of a new style of laparoscopic and endoscopic cooperative surgery (LECS), an improved method of laparoscopic intragastric surgery (LIGS) for the treatment of gastric stromal tumors (GSTs).
  
  
  METHODS
  Six patients were treated with the new-style LECS. Surgery was performed according to the following procedures: (1) Exposing and confirming the location of the tumor with gastroscopy; (2) A laparoscopy light was placed in the cavity using the trocar at the navel, and the other two trocars penetrated both the abdominal and stomach walls; (3) With gastroscopy monitoring, the operation was carried out in the gastric lumen using laparoscopic instruments and the tumor was resected; and (4) The tumor tissue was removed orally using a gastroscopy basket, and puncture holes and perforations were sutured using titanium clips.
  
  
  RESULTS
  Tumor size ranged from 2.0 to 4.5 cm (average 3.50 ± 0.84 cm). The operative time ranged from 60 to 130 min (average 83.33 ± 26.58 min). Blood loss was less than 20 mL and hospital stay ranged from 6 to 8 d (average 6.67 ± 0.82 d). The patients were allowed out of bed 12 h later. A stomach tube was inserted for 72 h after surgery, and a liquid diet was then taken. All cases had single tumors which were completely resected using the new-style LECS. No postoperative complications occurred. Pathology of all resected specimens showed GST: no cases of implantation or metastasis were found.
  
  
  CONCLUSIONS
  New-style LECS for GSTs is a quick, optimized, fast recovery, safe and effective therapy.
authors.affiliation: Department of Endoscopy, Qianfoshan Hospital Affiliated to Shandong University, Jinan 250014, Shandong Province, China.
authors.forename: Hai-Yan
authors.initials: HY
authors.lastname: Dong
authors.forename: Yu-Long
authors.initials: YL
authors.lastname: Wang
authors.forename: Jie
authors.initials: J
authors.lastname: Li
authors.forename: Qiu-Ping
authors.initials: QP
authors.lastname: Pang
authors.forename: Guo-Dong
authors.initials: GD
authors.lastname: Li
authors.forename: Xin-Yong
authors.initials: XY
authors.lastname: Jia
mesh_terms: D000328:Adult; D016063:Blood Loss, Surgical; D004750:Enteral Nutrition; D005240:Feasibility Studies; D005260:Female; D005743:Gastrectomy / Q000009:adverse effects / Q000379:methods*; D046152:Gastrointestinal Stromal Tumors / Q000473:pathology / Q000601:surgery*; D005773:Gastroscopy / Q000009:adverse effects; D006801:Humans; D010535:Laparoscopy / Q000009:adverse effects; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D013274:Stomach Neoplasms / Q000473:pathology / Q000601:surgery*; D013536:Suture Techniques; D013997:Time Factors; D016896:Treatment Outcome; D047368:Tumor Burden
keywords: Gastric stromal tumor; Laparoscopic and endoscopic cooperative surgery