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Surgical Endoscopy

, Volume 31, Issue 8, pp 3398–3404 | Cite as

Our experience with laparoscopic partial gastrectomy by the ‘lift-and-cut method’ for gastric gastrointestinal stromal tumor with maximal preservation of the remnant stomach

  • Shintaro OkumuraEmail author
  • Seiichiro Kanaya
  • Hisahiro Hosogi
  • Takeshi Ito
  • Susumu Miura
  • Toshihiro Okada
  • Norihiro Shimoike
  • Shin Akagawa
  • Hironori Kawada
  • Akira Arimoto
Dynamic Manuscript

Abstract

Background

Wedge resection is the most commonly used method in laparoscopic partial gastrectomy for gastric gastrointestinal stromal tumor (GIST). However, this method can involve inadvertent resection of additional gastric tissue and cause gastric deformation. To minimize the volume of resected gastric tissue, we have developed a laparoscopic partial gastrectomy with seromyotomy which we call the ‘lift-and-cut method’ for gastric GIST. Here, we report a case series of this surgery.

Method

First, the seromuscular layer around the tumor is cut. Because the mucosa and submucosa are extensible, the tumor is lifted toward the abdominal cavity. After sufficient lifting, the gastric tissue under the tumor is cut at the submucosal layer with a linear stapler (thus ‘lift-and-cut method’). Finally, the defect in the seromuscular layer is closed with a hand-sewn suture.

Results

From April 2011 to December 2015, 28 patients underwent laparoscopic partial gastrectomy by this method at Osaka Red Cross Hospital. Average operation time was 126 min (range 65–302 min) and average blood loss was 10 ml (range 0–200 ml). No intraoperative complications including tumor rupture or postoperative complications regarded as Clavien–Dindo Grade II or higher occurred. All patients took sufficient solid diet at discharge. Median postoperative hospital stay was 7 days (range 5–21 days). On median follow-up of 26.6 months (range 6–54 months), no recurrence was reported.

Conclusion

Laparoscopic partial gastrectomy by the lift-and-cut method is safe and simple, and widely applicable for gastric GIST.

Keywords

Gastrointestinal stromal tumor Laparoscopic Partial Gastrectomy 

Notes

Compliance with ethical standards

Disclosures

Seiichiro Kanaya has received personal fees from Covidien, Ethicon and Olympus unrelated to the submitted work. Shintaro Okumura, Hisahiro Hosogi, Takeshi Ito, Susumu Miura, Toshihiro Okada, Norihiro Shimoike, Shin Akagawa, Hironori Kawada and Akira Arimoto have no conflict of interest or financial ties to disclose.

Supplementary material

Supplementary material 1 (WMV 168927 kb)

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Copyright information

© Springer Science+Business Media New York 2016

Authors and Affiliations

  • Shintaro Okumura
    • 1
    Email author
  • Seiichiro Kanaya
    • 2
  • Hisahiro Hosogi
    • 3
  • Takeshi Ito
    • 2
  • Susumu Miura
    • 2
  • Toshihiro Okada
    • 2
  • Norihiro Shimoike
    • 2
  • Shin Akagawa
    • 2
  • Hironori Kawada
    • 2
  • Akira Arimoto
    • 2
  1. 1.Department of SurgeryKyoto University Graduate School of MedicineKyotoJapan
  2. 2.Department of SurgeryOsaka Red-Cross HospitalOsakaJapan
  3. 3.Department of SurgeryKyoto City HospitalKyotoJapan

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