title: Combination of Laparoscopic and Endoscopic Approaches to Neoplasia with Non-exposure Technique (CLEAN-NET) for GIST with Ulceration.
abstract: Combination of laparoscopic and endoscopic approaches to neoplasia with non-exposure technique (CLEAN-NET) was developed to avoid intraoperative tumor dissemination. We report two cases of gastric gastrointestinal stromal tumor (GIST) with ulceration surgically treated with CLEAN-NET at our institution. The first case was a 55-year-old male with hematemesis. Gastric endoscopy revealed a gastric GIST with ulceration of the fornix. CLEAN-NET was performed with the insertion of five trocars and a liver retractor. The operative time was 202 min (including cholecystectomy), with a perioperative blood loss volume of 29 ml; the postoperative hospital stay duration was 8 days. The second case was a 66-year-old male with a gastric submucosal tumor (SMT) with ulceration. CLEAN-NET was performed in a similar fashion to the first case. The operative time was 128 min, with a preoperative blood loss volume of 16 ml; the postoperative hospital stay duration was 9 days. In conclusion, CLEAN-NET was found to be safe and useful in the treatment of gastric GIST with ulceration.
authors.affiliation: Department of Surgery, Tokai University School of Medicine, 143 Shimokasuya, Isehara, Kanagawa 259-1193, Japan. nabesima@is.icc.u-tokai.ac.jp.
authors.forename: Kazuhito
authors.initials: K
authors.lastname: Nabeshima
authors.forename: Mifuji
authors.initials: M
authors.lastname: Tomioku
authors.forename: Kenji
authors.initials: K
authors.lastname: Nakamura
authors.forename: Seiei
authors.initials: S
authors.lastname: Yasuda
mesh_terms: D000368:Aged; D016063:Blood Loss, Surgical; D016099:Endoscopy, Gastrointestinal / Q000379:methods*; D046152:Gastrointestinal Stromal Tumors / Q000473:pathology* / Q000601:surgery*; D006801:Humans; D010535:Laparoscopy / Q000379:methods*; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D009366:Neoplasm Seeding; D061646:Operative Time; D016896:Treatment Outcome; D014456:Ulcer / Q000473:pathology* / Q000601:surgery*