title: Hybrid natural orifice transluminal endoscopic surgery in gastric subepithelial tumors.
abstract: Diagnosis of gastric subepithelial tumor (SET) has shown a rapid increase worldwide. Although, until now, endoscopic ultrasound guided procedures such as fine needle aspiration have shown relatively high accuracy in diagnosis of SET, the most important modality for diagnosis and treatment of SETs is complete resection such as endoscopic or surgical resection. However, endoscopic resection or laparoscopic wedge resection alone also has some limitations. Endoscopic resection is difficult to perform in cases of gastric SET located within deep portion of the gastric layer or a relatively large (larger than 25 mm diameter). On the other hand, gastric SET in a difficult location, such as the gastroesophageal junction or pyloric ring is challenging for laparoscopic surgical resection. The hybrid natural orifice transluminal endoscopic surgery (NOTES) technique is a combined method, including the advantages of both laparoscopic resection and endoscopic resection for gastric SETs. This method may be performed safely with reasonable operation times, less bleeding, and adequate resection margin and regardless of tumor size. In particular, in the case of a difficult location for resection, such as the esophagogastric junction or pyloric ring, hybrid NOTES is currently believed to be an ideal treatment method.
authors.affiliation: Jun Heo, Seong Woo Jeon, Department of Internal Medicine, Kyungpook National University School of Medicine, Daegu 702-911, South Korea.
authors.forename: Jun
authors.initials: J
authors.lastname: Heo
authors.forename: Seong Woo
authors.initials: SW
authors.lastname: Jeon
keywords: Endoscopic ultrasound; Hybrid natural orifice transluminal endoscopic surgery; Subepithelial tumor
references.citation: Surg Endosc. 2000 Apr;14(4):349-53
references.pmid: 10790553
references.citation: J Gastrointest Surg. 2003 Mar-Apr;7(3):386-92
references.pmid: 12654564
references.citation: Surg Endosc. 2009 Aug;23(8):1908-13
references.pmid: 19184206
references.citation: Gastrointest Endosc. 2004 Jul;60(1):114-7
references.pmid: 15229442
references.citation: Surg Laparosc Endosc Percutan Tech. 2004 Feb;14(1):1-4
references.pmid: 15259576
references.citation: Gastrointest Endosc. 2005 Aug;62(2):209-12
references.pmid: 16046980
references.citation: J Laparoendosc Adv Surg Tech A. 1999 Feb;9(1):63-7
references.pmid: 10194695
references.citation: World J Surg. 2008 Jun;32(6):1021-8
references.pmid: 18338207
references.citation: Gastrointest Endosc. 2010 Jan;71(1):188-94
references.pmid: 19879567
references.citation: Surg Endosc. 2004 Oct;18(10):1469-74
references.pmid: 15791371
references.citation: Gastrointest Endosc. 2010 May;71(6):913-9
references.pmid: 20226456
references.citation: World J Surg. 2012 Feb;36(2):327-30
references.pmid: 22187132
references.citation: Surg Endosc. 1997 Mar;11(3):287-9
references.pmid: 9079613
references.citation: Endoscopy. 2012 Mar;44(3):231-5
references.pmid: 22354823
references.citation: Surg Endosc. 2008 Jul;22(7):1729-35
references.pmid: 18074180
references.citation: Surg Endosc. 2002 Jan;16(1):177-9
references.pmid: 11961634
references.citation: Surg Today. 1999;29(2):102-6
references.pmid: 10030732
references.citation: Surg Endosc. 1997 Mar;11(3):277-9
references.pmid: 9079609
references.citation: Surg Endosc. 1999 Jan;13(1):71-4
references.pmid: 9869694
references.citation: Surg Endosc. 2009 Sep;23(9):1980-7
references.pmid: 18470554
references.citation: Surg Endosc. 2011 Sep;25(9):2926-31
references.pmid: 21424195
references.citation: Hepatogastroenterology. 1999 May-Jun;46(27):2100-4
references.pmid: 10430405