title: Laparoscopy-assisted endoscopic full-thickness resection for gastric subepithelial tumors originated from the muscularis propria layer: a pilot study with literature review.
abstract: OBJECTIVE
  Laparoscopy-assisted endoscopic full-thickness resection (LAEFTR) has been suggested as an alternative to laparoscopic wedge resection in the treatment of gastric subepithelial tumors (SETs). It is expected to minimize the resection of the tissue surrounding the tumors and maintain the function of the remnant stomach. Here, we performed a prospective pilot study to evaluate the efficacy of laparoscopy-assisted endoscopic full-thickness resection (LAEFTR) for patients with gastric SETs.
  
  
  METHODS
  We enrolled twelve patients who were diagnosed with gastric SETs with an intraluminal growth pattern or which is located in the gastric antrum between October 2011 and September 2013. LAEFTR was performed endoscopically using an endoscopic knife to make an incision half way around the tumor circumference and a laparoscopic resection around the remaining tumor circumference, followed by its laparoscopic removal. The feasibility, safety, and effectiveness of LAEFTR for gastric SETs were evaluated.
  
  
  RESULTS
  The median size of the tumors in twelve patients was 22 mm (21-33). Of the 12 patients, 8 received LAEFTR, while the others underwent conventional laparoscopic wedge resection, since their tumor outlines were clearly visible in laparoscopic view. In 8 patients who underwent LAEFTR, the mean total operation time (endoscopic procedure time/laparoscopic procedure time) were 117 (37/41) min. The tumors were completely resected with clear margin, and there was no perioperative and postoperative complications.
  
  
  CONCLUSIONS
  LAEFTR currently seems to be the ideal treatment modality of intraluminal gastric SETs where their resection margins are difficult to define under laparoscopic guidance alone.
authors.affiliation: a Department of Gastroenterology , Ajou University School of Medicine , Suwon , Korea.
authors.forename: Sun Gyo
authors.initials: SG
authors.lastname: Lim
authors.affiliation: b Department of Surgery , Ajou University School of Medicine , Suwon , Korea.
authors.forename: Hoon
authors.initials: H
authors.lastname: Hur
authors.affiliation: b Department of Surgery , Ajou University School of Medicine , Suwon , Korea.
authors.forename: Sang-Uk
authors.initials: SU
authors.lastname: Han
authors.affiliation: a Department of Gastroenterology , Ajou University School of Medicine , Suwon , Korea.
authors.forename: Kee Myung
authors.initials: KM
authors.lastname: Lee
authors.affiliation: a Department of Gastroenterology , Ajou University School of Medicine , Suwon , Korea.
authors.forename: Joon Koo
authors.initials: JK
authors.lastname: Kang
authors.affiliation: a Department of Gastroenterology , Ajou University School of Medicine , Suwon , Korea.
authors.forename: Sung Jae
authors.initials: SJ
authors.lastname: Shin
authors.affiliation: b Department of Surgery , Ajou University School of Medicine , Suwon , Korea.
authors.forename: Yong Kwan
authors.initials: YK
authors.lastname: Cho
authors.affiliation: a Department of Gastroenterology , Ajou University School of Medicine , Suwon , Korea.
authors.forename: Jin Hong
authors.initials: JH
authors.lastname: Kim
mesh_terms: D000328:Adult; D000368:Aged; D004210:Dissection; D005260:Female; D005773:Gastroscopy; D006801:Humans; D010535:Laparoscopy; D008297:Male; D008875:Middle Aged; D061646:Operative Time; D010865:Pilot Projects; D011183:Postoperative Complications; D011446:Prospective Studies; D056910:Republic of Korea; D013274:Stomach Neoplasms / Q000473:pathology / Q000601:surgery*; D016896:Treatment Outcome; D055815:Young Adult
keywords: Endoscopy; gastrointestinal; laparoscopy; stomach neoplasms; subepithelial tumors