title: Our experience with laparoscopic partial gastrectomy by the 'lift-and-cut method' for gastric gastrointestinal stromal tumor with maximal preservation of the remnant stomach.
abstract: Wedge resection is the most commonly used method in laparoscopic partial gastrectomy for gastric gastrointestinal stromal tumor (GIST). However, this method can involve inadvertent resection of additional gastric tissue and cause gastric deformation. To minimize the volume of resected gastric tissue, we have developed a laparoscopic partial gastrectomy with seromyotomy which we call the 'lift-and-cut method' for gastric GIST. Here, we report a case series of this surgery.
  
  
  
  First, the seromuscular layer around the tumor is cut. Because the mucosa and submucosa are extensible, the tumor is lifted toward the abdominal cavity. After sufficient lifting, the gastric tissue under the tumor is cut at the submucosal layer with a linear stapler (thus 'lift-and-cut method'). Finally, the defect in the seromuscular layer is closed with a hand-sewn suture.
  
  
  
  From April 2011 to December 2015, 28 patients underwent laparoscopic partial gastrectomy by this method at Osaka Red Cross Hospital. Average operation time was 126 min (range 65-302 min) and average blood loss was 10 ml (range 0-200 ml). No intraoperative complications including tumor rupture or postoperative complications regarded as Clavien-Dindo Grade II or higher occurred. All patients took sufficient solid diet at discharge. Median postoperative hospital stay was 7 days (range 5-21 days). On median follow-up of 26.6 months (range 6-54 months), no recurrence was reported.
  
  
  
  Laparoscopic partial gastrectomy by the lift-and-cut method is safe and simple, and widely applicable for gastric GIST.
authors.affiliation: Department of Surgery, Kyoto University Graduate School of Medicine, 54 Shogoin-Kawahara-Cho, Sakyo-Ku, Kyoto, 606-8507, Japan. s_okumura0506@tuba.ocn.ne.jp.
authors.forename: Shintaro
authors.initials: S
authors.lastname: Okumura
authors.affiliation: Department of Surgery, Osaka Red-Cross Hospital, Osaka, Japan.
authors.forename: Seiichiro
authors.initials: S
authors.lastname: Kanaya
authors.affiliation: Department of Surgery, Kyoto City Hospital, Kyoto, Japan.
authors.forename: Hisahiro
authors.initials: H
authors.lastname: Hosogi
authors.affiliation: Department of Surgery, Osaka Red-Cross Hospital, Osaka, Japan.
authors.forename: Takeshi
authors.initials: T
authors.lastname: Ito
authors.affiliation: Department of Surgery, Osaka Red-Cross Hospital, Osaka, Japan.
authors.forename: Susumu
authors.initials: S
authors.lastname: Miura
authors.affiliation: Department of Surgery, Osaka Red-Cross Hospital, Osaka, Japan.
authors.forename: Toshihiro
authors.initials: T
authors.lastname: Okada
authors.affiliation: Department of Surgery, Osaka Red-Cross Hospital, Osaka, Japan.
authors.forename: Norihiro
authors.initials: N
authors.lastname: Shimoike
authors.affiliation: Department of Surgery, Osaka Red-Cross Hospital, Osaka, Japan.
authors.forename: Shin
authors.initials: S
authors.lastname: Akagawa
authors.affiliation: Department of Surgery, Osaka Red-Cross Hospital, Osaka, Japan.
authors.forename: Hironori
authors.initials: H
authors.lastname: Kawada
authors.affiliation: Department of Surgery, Osaka Red-Cross Hospital, Osaka, Japan.
authors.forename: Akira
authors.initials: A
authors.lastname: Arimoto
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D005743:Gastrectomy / Q000379:methods*; D018530:Gastric Stump; D046152:Gastrointestinal Stromal Tumors / Q000601:surgery*; D006801:Humans; D010535:Laparoscopy / Q000379:methods*; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000601:surgery*; D012189:Retrospective Studies; D013274:Stomach Neoplasms / Q000601:surgery*; D016896:Treatment Outcome
keywords: Gastrectomy; Gastrointestinal stromal tumor; Laparoscopic; Partial