Minimally invasive resections of gastric tumors

Background. Submucosal and mucosal gastric tumors occur infrequently and have a highly variable clinical course. Materials and methods. Between 1996 and 2001,44 patients with tumors of the stomach wall underwent a laparoscopic local resection in three different procedures and were analyzed prospectively. Results. Laparoscopic resections were performed on 44 patients (21 female, 23 male). The mean age of the patients was 65.3 years (range: 23-78). We performed the laparoscopic intragastric resection (LIR) on 18,the full thickness resection (LVR) on 17,and the extramucosal enucleation (LER) on 9 patients. The laparoscopic resection was combined with endoscopy in 24 patients. The immunohistological examination of the specimens showed gastrointestinal stroma cell tumors (GIST) in 24 cases, leiomyomas in 10 cases,adenomas in 2 cases, neurinomas or benign neurofibromas in 4 cases, neuroendocrine tumors (NET) in 2 cases,and an ectopic pancreas islet in 1 patient. In all of these patients,the surgical margins in the pathological specimens were tumor-free without lymphatic or venous invasion. None of the patients with GIST or NET had distant metastases. Intraoperative complications occurred in three cases (6.8%). Two repeat laparoscopic procedures (4.6%) were necessary. No fatal outcome or relapse in the follow-up over 23.4 months (range: 1-74) was registered. Conclusions. Laparoscopic or laparoendoscopic resection of gastric tumors is practicable with relatively few of complications. The level of patient comfort is high.