title: Endoscopic-assisted laparoscopic resection for gastric subepithelial tumors.
abstract: BACKGROUND
  Laparoscopic resection is considered the treatment of choice for gastric subepithelial tumors. Occasionally, it is necessary to perform an intraoperative gastroscopy to localize the lesion. There are no data in the literature addressing the factors that can predict when a combined laparoscopic-endoscopic approach will be needed.
  
  
  METHODS
  A retrospective cohort study using a prospectively collected database was conducted. From January 2005 to December 2013, all the patients undergoing a laparoscopic gastric resection for subepithelial tumors irresectable by endoscopy were reviewed. Potential predictive factors for the need of an intraoperative endoscopy were analyzed.
  
  
  RESULTS
  Thirty-eight consecutive patients (22 men and 16 women) with a mean age of 67 (41-86) years underwent laparoscopic gastric resection for subepithelial tumors. Fourteen (36.8%) patients required intraoperative endoscopic assessment. The only significant factors related to the need of endoscopic assessment during surgery were tumor growth pattern (P = 0.002) and size (P = 0.001).
  
  
  CONCLUSIONS
  An accurate description of tumor growth pattern and size by EUS is recommended in the preoperative assessment of gastric subepithelial tumors. Small tumors (≤18 mm) with an intraluminal growth may need a combined endoscopic-assisted laparoscopic management.
authors: Department of General and Digestive Surgery, ICMDM, IDIBAPS, CIBEREHD, Hospital Clínic, Universitat de Barcelona, Villarroel 170, 08036, Barcelona, Spain.
authors: Jaime Sampson
authors: JS
authors: Dávila
authors: Department of General and Digestive Surgery, ICMDM, IDIBAPS, CIBEREHD, Hospital Clínic, Universitat de Barcelona, Villarroel 170, 08036, Barcelona, Spain.
authors: Dulce
authors: D
authors: Momblán
authors: Endoscopy Unit, Gastroenterology Department, ICMDM, IDIBAPS, CIBEREHD, Hospital Clínic, Universitat de Barcelona, Villarroel 170, 08036, Barcelona, Spain.
authors: Àngels
authors: À
authors: Ginès
authors: Endoscopy Unit, Gastroenterology Department, ICMDM, IDIBAPS, CIBEREHD, Hospital Clínic, Universitat de Barcelona, Villarroel 170, 08036, Barcelona, Spain.
authors: Cristina
authors: C
authors: Sánchez-Montes
authors: Endoscopy Unit, Gastroenterology Department, ICMDM, IDIBAPS, CIBEREHD, Hospital Clínic, Universitat de Barcelona, Villarroel 170, 08036, Barcelona, Spain.
authors: Isis
authors: I
authors: Araujo
authors: Department of General and Digestive Surgery, ICMDM, IDIBAPS, CIBEREHD, Hospital Clínic, Universitat de Barcelona, Villarroel 170, 08036, Barcelona, Spain.
authors: David
authors: D
authors: Saavedra-Pérez
authors: Department of General and Digestive Surgery, ICMDM, IDIBAPS, CIBEREHD, Hospital Clínic, Universitat de Barcelona, Villarroel 170, 08036, Barcelona, Spain. alacy@clinic.ub.es.
authors: Antonio M
authors: AM
authors: Lacy
authors: Endoscopy Unit, Gastroenterology Department, ICMDM, IDIBAPS, CIBEREHD, Hospital Clínic, Universitat de Barcelona, Villarroel 170, 08036, Barcelona, Spain. mgfernan@clinic.ub.es.
authors: Gloria
authors: G
authors: Fernández-Esparrach
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015331:Cohort Studies; D005260:Female; D005743:Gastrectomy; D005753:Gastric Mucosa / Q000601:surgery*; D005773:Gastroscopy; D006801:Humans; D010535:Laparoscopy; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D013274:Stomach Neoplasms / Q000473:pathology / Q000601:surgery*
keywords: Endoscopic-assisted; Laparoscopy; Subepithelial tumors