LAPAROSCOPY-GUIDED EXTRACORPOREAL RESECTION OF EARLY GASTRIC-CARCINOMA

Background and Study Aims: Though endoscopic mucosal resection is successful for early gastric carcinoma, the indication for endoscopic mucosal resection appears to exclude larger early gastric carcinomas, We report here on our experience in resecting early gastric carcinoma using laparoscopy-guided partial resection of the stomach extracorporeally. Patients and Methods: Seven patients with early gastric carcinoma were treated surgically under laparoscopic guidance, After an inspection of the abdominal cavity by laparoscope through an umbilical port, a gastrofiberscope was then inserted into the stomach perorally, and confirmation of the site of the carcinoma was provided by illuminating the interior gastric wall endoscopically, The gastric wall portion including the carcinoma was then exteriorized through a small upper midline incision, and resected, The gastrotomy was sutured extracorporeally, and then repositioned inside the abdomen. Results: All the carcinomas were successfully resected extracorporeally, with cancer-free margins, Postoperative courses were uneventful, and the average period of hospitalization after the operation was ten days. Conclusions: This type of laparoscopy-guided partial resection of the stomach is expected to become more widely adopted as a treatment for early gastric carcinoma.