Outcomes of laparoscopic and endoscopic cooperative surgery for gastric submucosal tumors: A retrospective multicenter study at 21 Japanese institutions

IF 2.9 4区 医学 Q2 GASTROENTEROLOGY & HEPATOLOGY
Yoshikazu Hashimoto, Nobutsugu Abe, Souya Nunobe, Hirofumi Kawakubo, Tetsuya Sumiyoshi, Naohiro Yoshida, Yoshinori Morita, Masanori Terashima, Zenichiro Saze, Manabu Onimaru, Eigo Otsuji, Shu Hoteya, Haruhiro Yamashita, Takashi Fujimura, Tsuneo Oyama, Ken Ohata, Satoki Shichijo, Kazuaki Tanabe, Kiyohiko Shuto, Takashi Ikeya, Hisashi Shinohara, Satoshi Tanabe, Naoki Hiki
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Abstract

Aim

We conducted a multicenter study on classical laparoscopic and endoscopic cooperative surgery (LECS) and LECS-related procedures to retrospectively clarify the safety, problems, and mid-term outcomes of these methods after their coverage by the national health insurance.

Methods

A total of 201 patients who underwent classical LECS/LECS-related procedures for gastric submucosal tumors (G-SMTs) in 21 institutions affiliated with the Laparoscopy Endoscopy Cooperative Surgery Study Group from April 2014 to March 2016 were included. Data was retrospectively obtained from the patients' charts.

Results

The most common surgical procedure was classical LECS (155 patients, 77.1%), non-exposed endoscopic wall inversion surgery (22 patients, 11.4%), a combination of laparoscopic and endoscopic approaches to neoplasia with non-exposure technique (16 patients, 8%), and closed LECS (two patients, 1%). Only six (3%) patients underwent LECS with gastrostomy. The mean operative time and blood loss were 188.4 (70–462) minutes and 23.3 (0–793) g, respectively. Ten (5%) patients developed postoperative complications (Clavien–Dindo classification grade II or higher). Two patients needed reoperation due to postoperative bleeding or anastomotic leakage. All tumors were resected with negative margins. A total of 127 (63.2%) patients underwent follow-up observations for over 36 months, one of whom had a recurrence of peritoneal dissemination and one had poor oral intake.

Conclusion

Classical LECS and LECS-related procedures for G-SMTs have favorable short/mid-term outcomes.

胃粘膜下肿瘤腹腔镜和内镜合作手术的疗效:日本 21 家医疗机构的多中心回顾性研究。
目的:我们对经典腹腔镜和内镜合作手术(LECS)以及LECS相关手术进行了一项多中心研究,以回顾性地阐明这些方法纳入国家医疗保险后的安全性、问题和中期疗效:共纳入2014年4月至2016年3月期间在腹腔镜内镜合作手术研究小组下属21家机构接受经典LECS/LECS相关手术治疗胃粘膜下肿瘤(G-SMT)的201例患者。数据从患者病历中回顾性获得:最常见的手术方法是经典LECS(155例患者,77.1%)、非暴露内镜下壁倒转手术(22例患者,11.4%)、腹腔镜和内镜联合方法与非暴露技术治疗肿瘤(16例患者,8%)以及封闭式LECS(2例患者,1%)。只有六名患者(3%)接受了带胃造口术的 LECS。平均手术时间和失血量分别为 188.4 (70-462) 分钟和 23.3 (0-793) 克。10名患者(5%)出现了术后并发症(Clavien-Dindo分类II级或更高)。两名患者因术后出血或吻合口漏而需要再次手术。所有肿瘤均以阴性边缘切除。共有127名(63.2%)患者接受了超过36个月的随访观察,其中一名患者腹膜播散复发,一名患者口服效果不佳:结论:G-SMT 的经典 LECS 和 LECS 相关手术具有良好的短期/中期疗效。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
Annals of Gastroenterological Surgery
Annals of Gastroenterological Surgery GASTROENTEROLOGY & HEPATOLOGY-
CiteScore
5.30
自引率
11.10%
发文量
98
审稿时长
11 weeks
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