title: Various features of laparoscopic tailored resection for gastric submucosal tumors: a single institution's results for 168 patients.
abstract: Laparoscopic resection is a standard procedure for gastric submucosal tumors. Herein, we analyzed the features of various laparoscopic approaches.
  
  
  
  Between January 2007 and November 2013, 168 consecutive patients who underwent laparoscopic resection for gastric submucosal tumors were enrolled. Patients' demographics and clinicopathologic and perioperative data were reviewed retrospectively.
  
  
  
  Among the 168 patients, exogastric wedge resection was performed in 99 cases (58.9%), single-port intragastric resection was performed in 30 cases (17.9%), eversion technique was used in 17 cases (10.1%), transgastric resection was performed in 8 cases (4.8%), and single-port wedge resection was performed in 6 cases (3.6%). The remaining cases underwent single-port exogastric wedge resection, laparoscopic and endoscopic cooperative surgery, or major resection. Mean age was 56.8 ± 13.3 years, and body mass index was 24.0 ± 3.2 kg/m(2). Mean operation time was 96.1 ± 58.9 min; laparoscopic proximal gastrectomy had the longest operation time (3 cases, 291.7 ± 129.0 min). In contrast, the laparoscopic eversion technique had the shortest operation time (82.6 ± 32.8 min). Pathologic data revealed a mean tumor size of 2.9 ± 1.2 cm (with a range of 0.8-8.0 cm). Tumors were most common on the body (98 cases, 58.3%), followed by the fundus (44 cases, 26.2%). Exophytic growth occurred in 39 cases (23.2%), endophytic growth occurred in 89 cases (53.0%), and dumbbell-type growth occurred in 40 cases (23.8%). Gastrointestinal stromal tumors occurred in 130 cases (77.4%), and schwannomas occurred in 23 (13.7%). Thirteen patients had postoperative complications (delayed gastric emptying in 5, stricture in 3, bleeding in 3, others in 2). The mean follow-up period was 28.8 ± 20.8 months, and there were three recurrences (1.8%) at 6, 19 and 31 months after the initial surgery.
  
  
  
  For gastric submucosal tumors with appropriate locations and growth types, laparoscopic tailored resection which facilitates safer and more precise resection can be good alternative treatment option.
authors.affiliation: Department of Surgery, Biomedical Research Institute, Pusan National University Hospital, 179 Gudeok-Ro, Seo-Gu, Busan, 602-739, Korea.
authors.forename: Chang In
authors.initials: CI
authors.lastname: Choi
authors.affiliation: Department of Surgery, Pusan National University Yangsan Hospital, 20 Keumo-Ro, Mulgeum-Eup, Yangsan, Gyeongsangnamdo, 626-779, Korea.
authors.forename: Si Hak
authors.initials: SH
authors.lastname: Lee
authors.affiliation: Department of Surgery, Pusan National University Yangsan Hospital, 20 Keumo-Ro, Mulgeum-Eup, Yangsan, Gyeongsangnamdo, 626-779, Korea.
authors.forename: Sun Hwi
authors.initials: SH
authors.lastname: Hwang
authors.affiliation: Department of Surgery, Biomedical Research Institute, Pusan National University Hospital, 179 Gudeok-Ro, Seo-Gu, Busan, 602-739, Korea. dh2-kim@daum.net.
authors.forename: Dae Hwan
authors.initials: DH
authors.lastname: Kim
authors.affiliation: Department of Surgery, Biomedical Research Institute, Pusan National University Hospital, 179 Gudeok-Ro, Seo-Gu, Busan, 602-739, Korea.
authors.forename: Tae Yong
authors.initials: TY
authors.lastname: Jeon
authors.affiliation: Department of Surgery, Biomedical Research Institute, Pusan National University Hospital, 179 Gudeok-Ro, Seo-Gu, Busan, 602-739, Korea.
authors.forename: Dong Heon
authors.initials: DH
authors.lastname: Kim
authors.affiliation: Department of Pathology, Medical Research Institute, Pusan National University Hospital, 179 Gudeok-Ro, Seo-Gu, Busan, 602-739, Korea.
authors.forename: Do Youn
authors.initials: DY
authors.lastname: Park
mesh_terms: D005260:Female; D005743:Gastrectomy / Q000379:methods*; D005753:Gastric Mucosa / Q000473:pathology / Q000601:surgery; D006801:Humans; D010535:Laparoscopy / Q000379:methods*; D008297:Male; D008875:Middle Aged; D009442:Neurilemmoma / Q000473:pathology / Q000601:surgery*; D012189:Retrospective Studies; D013274:Stomach Neoplasms / Q000473:pathology / Q000601:surgery*; D016896:Treatment Outcome
keywords: Gastrectomy; Laparoscopy; Stomach neoplasm; Submucosal tumor; Surgical stapling; Tailored approach