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Laparoscopic ultrasound-guided resection of gastric submucosal tumors
R Santambrogio1, M Montorsi, L Schubert
1Department of Surgery, Unità di Chirurgia Bilio-pancreatica, University of Milano School of Medicine, Azienda Ospedaliera San Paolo, via A. di Rudinì 8, 20142, Milano, Italy. rsantambrogio@mclink.it
Background:
The laparoscopic resection of gastric stromal tumors is being performed with increased frequency. Wedge resection of anterior wall lesions is generally performed. The treatment of posterior wall lesions is still controversial.
Methods:
We report three cases of gastric submucosal tumors treated by a laparoscopic wedge resection of the stomach. All lesions were localized anterior gastric wall by intraoperative ultrasound on the. In the first patient the resection was performed with an endoscopic stapler; in the other patients, ultrasonic coagulation in association with an intracorporeal suture has been used.
Results:
All patients were successfully treated laparoscopically; there were no conversions to open surgery. In all cases the operative course was uneventful. The postoperative hospital stay ranged from 6 to 8 days.
Conclusions:
The results suggest that laparoscopic surgery is an adequate strategy for gastric submucosal neoplasms including gastrointestinal stromal tumors (GIST). Intraoperative ultrasound is very useful in the selection of the technical approach with or without the endoscopic stapler.