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Priego et al. Mini-invasive Surg 2018;2:6 Mini-invasive Surgery
DOI: 10.20517/2574-1225.2018.01

Original Article Open Access

Laparoscopic transgastric resection of
gastric submucosal tumor located near the
esophagogastric junction

Pablo Priego, Marta Cuadrado, Francisca García-Moreno, Pedro Carda, Julio Galindo

Division of Upper & GI, Bariatric and Minimally Invasive Surgery, Department of Surgery, Ramón y Cajal University Hospital, Madrid
28034, Spain.
Correspondence to: Dr. Pablo Priego, Division of Upper & GI, Bariatric and Minimally Invasive Surgery, Department of Surgery, Ramón y Cajal
University Hospital, Crta. De Colmenar Viejo Km 9,100, Madrid 28034, Spain. E-mail: papriego@hotmail.com

How to cite this article: Priego P, Cuadrado M, García-Moreno F, Carda P, Galindo J. Laparoscopic transgastric resection of gastric
submucosal tumor located near the esophagogastric junction. Mini-invasive Surg 2018;2:6.
http://dx.doi.org/10.20517/2574-1225.2018.01

Received: 9 Jan 2018 First Decision: 26 Feb 2018 Revised: 3 Mar 2018 Accepted: 6 Mar 2018 Published: 8 Apr 2018

Science Editor: Fernando A. M. Herbella Copy Editor: Jun-Yao Li Production Editor: Huan-Liang Wu

Abstract
Aim: Laparoscopic wedge resection is widely accepted as the choice of treatment for gastric submucosal tumors (GST).
However, tumors on the posterior wall at the esophagogastric junction (EGJ) are difficult to approach. Laparoscopic
transgastric resection (LTR) is a novel technique to remove gastric tumors that are unresectable by endoscopy due to
their size and location. The aim of the article is to assess the feasibility and oncological outcomes of this laparoscopic
approach for intraluminal GST located in the posterior wall and near the EGJ.

Methods: A retrospective analysis of all patients with GST located at the EGJ who underwent LTR at our institution from
January 2015 to February 2016 was performed.

Results: Of the 4 patients who underwent LTR, 3 were female and 1 was male, with a mean age of 74.5 years. LTR
was successfully performed in all the cases. All patients received a complete resection with negative margins.
Histopathologic diagnoses were gastrointestinal stromal tumor in 2 cases and leiomyoma in the other 2. Median
tumor size was 3.45 cm. The mean operation time was 173 min (range 120-232 min). One patient experienced a
postoperative hematemesis, but was treated conservatively. The mean postoperative stay was 8 days (range 4-15 days).

Conclusions: LTR is feasible and difficult localizations can be reached with ease. It is an appropriate alternative to
laparoscopic wedge resections especially for localizations that cannot be accessed by laparoscopy such as tumors
located near the EGJ.

Keywords: Gastrointestinal stromal tumors, esophagogastric junction, transgastric resection, laparoscopy, gastric
submucosal tumors, laparoscopic
© The Author(s) 2018. Open Access This article is licensed under a Creative Commons Attribution 4.0
International License (https://creativecommons.org/licenses/by/4.0/), which permits unrestricted use,
sharing, adaptation, distribution and reproduction in any medium or format, for any purpose, even commercially, as long
as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license,
and indicate if changes were made.

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