Clinical outcomes of non-exposed endoscopic wall-inversion surgery for gastric submucosal tumors: long-term follow-up and functional results

Junya Aoyama, Osamu Goto, Hirofumi Kawakubo, Shuhei Mayanagi, Kazumasa Fukuda, Tomoyuki Irino, Rieko Nakamura, Norihito Wada, Hiroya Takeuchi, Naohisa Yahagi, Yuukou Kitagawa

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Abstract

Background and aims: To avoid the risk of iatrogenic dissemination during procedures, we have developed a combined laparoscopic and endoscopic surgery with a nonexposure technique for resection of gastric tumors. The study aim was to evaluate the feasibility and safety of non-exposed endoscopic wall-inversion surgery (NEWS) for gastric submucosal tumors (SMTs). Methods: Between August 2013 and February 2018, NEWS was performed for 42 patients with gastric SMTs ≤ 3 cm in diameter at our institution. We retrospectively investigated the patients’ backgrounds, operative and perioperative outcomes, tumor pathological characteristics, and follow-up data. Results: All tumors were resected with negative margins by NEWS. The median operation time was 198 min, and the median estimated blood loss was 5.0 mL. Adverse events occurred in one patient with pneumonia. All patients were alive without recurrence within the median follow-up period of 29.2 months. The average body weight loss rate was 0.3 ± 4.0%. No food residue was observed at endoscopic follow-up. Conclusions: On the basis of slight body weight loss and the absence of food residue observed in the postoperative endoscopy, NEWS appeared to be safe and feasible for gastric SMTs and to preserve function of the remnant stomach.

Original languageEnglish
JournalGastric Cancer
DOIs
Publication statusPublished - 2019 Jan 1

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Stomach
Neoplasms
Weight Loss
Body Weight
Gastric Stump
Food
Laparoscopy
Endoscopy
Pneumonia
Safety
Recurrence

Keywords

  • Gastric remnant function
  • Gastric submucosal tumors
  • Laparoscopic endoscopic co-operative surgery

ASJC Scopus subject areas

  • Oncology
  • Gastroenterology
  • Cancer Research

Cite this

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title = "Clinical outcomes of non-exposed endoscopic wall-inversion surgery for gastric submucosal tumors: long-term follow-up and functional results",
abstract = "Background and aims: To avoid the risk of iatrogenic dissemination during procedures, we have developed a combined laparoscopic and endoscopic surgery with a nonexposure technique for resection of gastric tumors. The study aim was to evaluate the feasibility and safety of non-exposed endoscopic wall-inversion surgery (NEWS) for gastric submucosal tumors (SMTs). Methods: Between August 2013 and February 2018, NEWS was performed for 42 patients with gastric SMTs ≤ 3 cm in diameter at our institution. We retrospectively investigated the patients’ backgrounds, operative and perioperative outcomes, tumor pathological characteristics, and follow-up data. Results: All tumors were resected with negative margins by NEWS. The median operation time was 198 min, and the median estimated blood loss was 5.0 mL. Adverse events occurred in one patient with pneumonia. All patients were alive without recurrence within the median follow-up period of 29.2 months. The average body weight loss rate was 0.3 ± 4.0{\%}. No food residue was observed at endoscopic follow-up. Conclusions: On the basis of slight body weight loss and the absence of food residue observed in the postoperative endoscopy, NEWS appeared to be safe and feasible for gastric SMTs and to preserve function of the remnant stomach.",
keywords = "Gastric remnant function, Gastric submucosal tumors, Laparoscopic endoscopic co-operative surgery",
author = "Junya Aoyama and Osamu Goto and Hirofumi Kawakubo and Shuhei Mayanagi and Kazumasa Fukuda and Tomoyuki Irino and Rieko Nakamura and Norihito Wada and Hiroya Takeuchi and Naohisa Yahagi and Yuukou Kitagawa",
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T1 - Clinical outcomes of non-exposed endoscopic wall-inversion surgery for gastric submucosal tumors

T2 - long-term follow-up and functional results

AU - Aoyama, Junya

AU - Goto, Osamu

AU - Kawakubo, Hirofumi

AU - Mayanagi, Shuhei

AU - Fukuda, Kazumasa

AU - Irino, Tomoyuki

AU - Nakamura, Rieko

AU - Wada, Norihito

AU - Takeuchi, Hiroya

AU - Yahagi, Naohisa

AU - Kitagawa, Yuukou

PY - 2019/1/1

Y1 - 2019/1/1

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AB - Background and aims: To avoid the risk of iatrogenic dissemination during procedures, we have developed a combined laparoscopic and endoscopic surgery with a nonexposure technique for resection of gastric tumors. The study aim was to evaluate the feasibility and safety of non-exposed endoscopic wall-inversion surgery (NEWS) for gastric submucosal tumors (SMTs). Methods: Between August 2013 and February 2018, NEWS was performed for 42 patients with gastric SMTs ≤ 3 cm in diameter at our institution. We retrospectively investigated the patients’ backgrounds, operative and perioperative outcomes, tumor pathological characteristics, and follow-up data. Results: All tumors were resected with negative margins by NEWS. The median operation time was 198 min, and the median estimated blood loss was 5.0 mL. Adverse events occurred in one patient with pneumonia. All patients were alive without recurrence within the median follow-up period of 29.2 months. The average body weight loss rate was 0.3 ± 4.0%. No food residue was observed at endoscopic follow-up. Conclusions: On the basis of slight body weight loss and the absence of food residue observed in the postoperative endoscopy, NEWS appeared to be safe and feasible for gastric SMTs and to preserve function of the remnant stomach.

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