title: Minimally invasive treatment of laparoscopic and endoscopic cooperative surgery for patients with gastric gastrointestinal stromal tumors.
abstract: OBJECTIVE
  To evaluate the feasibility and safety of laparoscopic and endoscopic cooperative surgery (LECS) for the treatment of gastric gastrointestinal stromal tumors (GISTs).
  
  
  METHODS
  We retrospectively reviewed the data of 69 consecutive patients who underwent LECS, including laparoscopy-assisted endoscopic resection (LAER) and endoscopy-assisted laparoscopic wedge resection (EAWR), for pathologically confirmed gastric GISTs of less than 5 cm in diameter from January 2006 to October 2012.
  
  
  RESULTS
  The tumor was located at the upper third of the stomach in 22 patients, the middle third in 38 and the lower third in nine, with a mean tumor size of 2.8 ± 1.6 cm. The operating time was 81.6 ± 31.8 min in the LAER group and 86.3 ± 28.5 min in the EAWR group (P = 0.776). Intraoperative blood loss was 29.8 ± 15.4 mL in the LAER group and 31.4 ± 11.6 mL in the EAWR group (P = 0.561). Most patients had a very low or low risk of tumor recurrence, while six had an intermediate risk of tumor recurrence. The mean length of postoperative hospital stay was 4.6 days. Only two patients had postoperative complications after LECS, both of whom were treated successfully without open surgery. During a median follow-up of 35 months, all patients were disease-free, with no tumor recurrence or metastases.
  
  
  CONCLUSIONS
  LECS is a minimally invasive and safe alternative approach which can achieve fast recovery and satisfactory short-term outcomes for appropriately selected patients with gastric GISTs.
authors.affiliation: Department of General Surgery, School of Medicine, Shanghai Jiao Tong University, Shanghai, China.
authors.forename: Wei Qing
authors.initials: WQ
authors.lastname: Qiu
authors.forename: Jie
authors.initials: J
authors.lastname: Zhuang
authors.forename: Ming
authors.initials: M
authors.lastname: Wang
authors.forename: Hua
authors.initials: H
authors.lastname: Liu
authors.forename: Zhi Yong
authors.initials: ZY
authors.lastname: Shen
authors.forename: Han Bing
authors.initials: HB
authors.lastname: Xue
authors.forename: Lei
authors.initials: L
authors.lastname: Shen
authors.forename: Zhi Zheng
authors.initials: ZZ
authors.lastname: Ge
authors.forename: Hui
authors.initials: H
authors.lastname: Cao
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D016063:Blood Loss, Surgical; D005240:Feasibility Studies; D005260:Female; D046152:Gastrointestinal Stromal Tumors / Q000473:pathology / Q000601:surgery*; D005773:Gastroscopy / Q000009:adverse effects / Q000379:methods*; D006801:Humans; D010535:Laparoscopy / Q000009:adverse effects / Q000379:methods*; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D013274:Stomach Neoplasms / Q000473:pathology / Q000601:surgery*; D016896:Treatment Outcome
keywords: endoscopy; gastrointestinal stromal tumor; laparoscopic and endoscopic cooperative surgery; laparoscopy; therapy