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[A Case of Inverted LECS for GIST Near the Pylorus Ring]
Megumi Watanabe1, Susumu Doita, Hitoshi Minagi
1Dept. of Surgery, National Hospital Organization Iwakuni Clinical Center.
Gan to Kagaku Ryoho. Cancer & Chemotherapy
|February 3, 2023
Summary
Inverted Laparoscopy and Endoscopy Cooperative Surgery (LECS) successfully treated a gastric gastrointestinal stromal tumor (GIST) near the pylorus. This technique preserves pyloric function, avoiding obstruction and stasis.
Area of Science:
- Gastroenterology
- Surgical Oncology
Background:
- Laparoscopy and Endoscopy Cooperative Surgery (LECS) is a minimally invasive technique to resect gastrointestinal tumors while preserving organ function.
- Gastrointestinal stromal tumors (GIST) near the pylorus present a surgical challenge due to the risk of impairing gastric emptying.
Observation:
- A 58-year-old male patient presented with a 45 mm subepithelial tumor near the pylorus, diagnosed as gastric GIST via endoscopic ultrasound-guided fine-needle aspiration (EUS-FNA).
- The tumor was successfully resected using an inverted LECS approach, with the defect closed by hand-sewn sutures, creating an L-shaped closure.
Findings:
- The inverted LECS procedure allowed for complete tumor removal while preserving the function of the pylorus.
- The patient experienced a favorable postoperative recovery, being discharged 10 days after the surgery without complications.
Implications:
- This case demonstrates that inverted LECS is a viable and effective option for treating gastric GIST near the pylorus.
- Devising the closure direction in LECS can maintain pyloric function, preventing passage obstruction and gastric stasis, even for tumors in this critical location.
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