Closed laparoscopic and endoscopic cooperative surgery for early gastric cancer with difficulty in endoscopic submucosal dissection: a report of three cases

Surgical Case Reports

Kaichiro Kato¹  Hiroshi Saito¹  Hirotaka Kitamura¹  Hiroyuki Bando¹  Daisuke Yamamoto¹  Hiroki Tawara¹  Yusuke Sakimura¹  Toshikatsu Tsuji¹  Shinichi Kadoya¹  Akihiro Nishimura¹  Kengo Hayashi¹ 

[1] Department of Gastroenterological Surgery, Ishikawa Prefectural Central Hospital, Kuratsuki-Higashi 2-1, Kanazawa, Ishikawa, Japan;

关键词: Endoscopic submucosal dissection;    Closed laparoscopic and endoscopic cooperative surgery;    Early gastric cancer;   

DOI  :  10.1186/s40792-020-01015-4

来源: Springer

【 摘 要 】

BackgroundEndoscopic submucosal dissection (ESD) is increasingly applied for early gastric cancer. ESD is a less invasive procedure and could be a radical treatment. However, in some cases, ESD cannot be completed owing to patient or technical factors. In such cases, which could have the potential for curative resection with ESD, standard gastrectomy is excessively invasive. Through closed laparoscopic and endoscopic cooperative surgery (LECS), gastric tumor can be precisely resected without exposing tumor cells to the abdominal cavity. Compared with standard gastrectomy, closed LECS is less invasive for the treatment of early gastric cancer.Case presentationWe performed closed LECS for three cases of early gastric cancer after failed ESD. In all three cases, ESD was interrupted owing to technical and patient factors, including perforation, respiratory failure, and carbon dioxide narcosis. All three cases successfully underwent closed LECS with complete tumor resection and showed an uneventful postoperative course. All three patients remain alive and have experienced no complications or recurrence, with a median follow up of 30 (14–30) months.ConclusionsClosed LECS is less invasive and useful procedure for the treatment of early gastric cancer, particularly in cases with difficulty in ESD.

【 授权许可】

CC BY