Cutting edge of endoscopic full-thickness resection for gastric tumor |
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Authors: | Tadateru Maehata Osamu Goto Hiroya Takeuchi Yuko Kitagawa Naohisa Yahagi |
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Institution: | Tadateru Maehata, Osamu Goto, Naohisa Yahagi, Division of Research and Development for Minimally Invasive Treatment, Cancer Center, Keio University, School of Medicine, Tokyo 160-8582, JapanHiroya Takeuchi, Yuko Kitagawa, Department of Surgery, Keio University, School of Medicine, Tokyo 160-8582, Japan |
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Abstract: | Recently,several studies have reported local full-thickness resection techniques using flexible endoscopy for gastric tumors,such as gastrointestinal stromal tumors,gastric carcinoid tumors,and early gastric cancer(EGC). These techniques have the advantage of allowing precise resection lines to be determined using intraluminal endoscopy. Thus,it is possible to minimize the resection area and subsequent deformity. Some of these methods include:(1) classical laparoscopic and endoscopic cooperative surgery(LECS);(2) inverted LECS;(3) combination of laparoscopic and endoscopic approaches to neoplasia with non-exposure technique; and(4) non-exposed endoscopic wall-inversion surgery. Furthermore,a recent prospective multicenter trial of the sentinel node navigation surgery(SNNS) for EGC has shown acceptable results in terms of sentinel node detection rate and the accuracy of nodal metastasis. Endoscopic full-thickness resection with SNNS is expected to become a treatment option that bridges the gap between endoscopic submucosal dissection and standard surgery for EGC. In the future,the indications for these procedures for gastric tumors could be expanded. |
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Keywords: | Gastrointestinal stromal tumor Early gastric cancer Full-thickness resection Laparoscopic and endoscopic cooperative surgery Sentinel node navigation surgery |
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