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  • Title: Laparoscopic treatment of gastric tumors.
    Author: Feliu X, Besora P, Clavería R, Viñas X, Salazar D, Fernández E.
    Journal: J Laparoendosc Adv Surg Tech A; 2007 Apr; 17(2):147-52. PubMed ID: 17484639.
    Abstract:
    PURPOSE: To assess the use of different laparoscopic approaches in the management of gastric tumors based on tumor type and location. MATERIALS AND METHODS: Between March 2002 and June 2005, 23 consecutive patients with gastric lesions were treated with laparoscopy procedures. Six patients presented with stromal tumors, 5 with benign lesions, and 12 with resectable gastric cancers. RESULTS: The patients were 13 men and 10 women, mean age 66.2 +/- 11.1 years (range, 29-84 years). Five laparoscopic gastric wedge resections, 6 intragastric submucosal resections, and 12 gastrectomies (10 subtotal and 2 total) were performed. Mean operative time was 49.1 +/- 18.8 minutes (range, 30-85 minutes) in the gastrointestinal stromal tumors and 64.1 +/- 19.2 minutes (range, 45-90 minutes) in benign tumors. Gastrectomy required an average of 197.6 +/- 36.9 minutes (range, 130-260 minutes). The mean times were 142.5 +/- 9.6 minutes in the subtotal gastrectomy group with extracorporeal anastomosis and 190.8 +/- 20.1 minutes when the anastomosis was totally laparoscopic (P < 0.002). All procedures were completed laparoscopically and there were no intraoperative complications. There were four postoperative complications: one wall hematoma secondary to the introduction of a trocar, one prolonged ileus, one intra-abdominal abscess, and one esophagojejunal leakage. Gastrointestinal stromal tumor patients were discharged after a mean 5.8 +/- 1.3 days; patients with benign pathology after 5.2 +/- 0.9 days, and gastric cancer patients after 10.7 +/- 7.3 days (range, 6-28 days). The mean number of dissected lymph nodes in gastric cancer was 21.3 (range, 16-31). CONCLUSION: Laparoscopic treatment of gastric lesions is technically feasible and safe. Compared to conventional surgery, it offers the advantages of low invasiveness and improved quality of life.
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