title: Successful laparoscopic gastric resection and safe introduction of a single-incision technique for gastric submucosal tumors located near the esophagogastric junction.
abstract: OBJECTIVE
  Laparoscopic gastric resection cannot be easily applied for submucosal tumors near the esophagogastric junction (NEJ-SMTs). Furthermore, there have been no reports of single-incision laparoscopic surgery (SILS) for NEJ-SMTs. We evaluated our laparoscopic surgical outcomes for NEJ-SMTs, including a newly introduced phase of SILS.
  
  
  METHODS
  We retrospectively reviewed a total of 18 patients diagnosed with NEJ-SMTs who underwent laparoscopic surgery between April 2002 and September 2013.
  
  
  RESULTS
  All patients underwent laparoscopic gastric resection without local complications and with a negative surgical margin, including 12 patients treated with conventional laparoscopic surgery (CLS) and six patients treated with SILS. The mean length of the operation was 184.3 ± 52.3 min, and the mean blood loss was 19.2 ± 17.7 mL. All patients underwent complete resection. There were no statistically significant differences between the CLS and SILS groups in terms of the surgical outcomes.
  
  
  CONCLUSIONS
  Despite this challenging location of the tumor, laparoscopic gastric resection for NEJ-SMTs is safe and feasible. Furthermore, SILS can provide a better cosmetic result, which can lead to better global patient satisfaction in carefully selected patients with NEJ-SMTs.
authors.affiliation: Division of Gastrointestinal Surgery, Department of Surgery, Graduate School of Medicine, Kobe University, 7-5-2, Kusunoki-cho Chuo-ku, Kobe, Hyogo, 650-0017, Japan, kanashin@med.kobe-u.ac.jp.
authors.forename: Shingo
authors.initials: S
authors.lastname: Kanaji
authors.forename: Tetsu
authors.initials: T
authors.lastname: Nakamura
authors.forename: Masashi
authors.initials: M
authors.lastname: Yamamoto
authors.forename: Tatsuya
authors.initials: T
authors.lastname: Imanishi
authors.forename: Satoshi
authors.initials: S
authors.lastname: Suzuki
authors.forename: Kenichi
authors.initials: K
authors.lastname: Tanaka
authors.forename: Daisuke
authors.initials: D
authors.lastname: Kuroda
authors.forename: Yoshihiro
authors.initials: Y
authors.lastname: Kakeji
mesh_terms: D000328:Adult; D000368:Aged; D004943:Esophagogastric Junction; D005260:Female; D005743:Gastrectomy / Q000379:methods*; D005753:Gastric Mucosa / Q000601:surgery*; D006801:Humans; D010535:Laparoscopy / Q000379:methods*; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D013274:Stomach Neoplasms / Q000601:surgery*; D016896:Treatment Outcome