Evaluating the laparoscopic approach to proximally located benign gastric tumors

Özet

Introduction: The aim of this study was to evaluate the surgical and histopathological outcomes of proximally located benign gastric tumors.Materials and Methods: This retrospective study included 14 patients with a proximally localized gastrictumor classified as Siewert III that was diagnosed between January 1, 2010 and December 31, 2019 in thegeneral surgery clinics of Cerrahpasa Medicine Faculty Hospital or Acıbadem Kozyatağı Hospital. Patientswho underwent laparoscopic and open surgery were included. Details of the patient characteristics, theclinical and pathological features of the tumors, and the patients’ perioperative and postoperative resultswere recorded and analyzed.Results: The most common cause of hospital admission was gastric bleeding (28.6%). Localization of thetumor was the lesser curvature in 42.9%, the posterior wall in 28.6%, the anterior wall in 21.4%, and thefundus in 7.1%. Seven of the 10 laparoscopic operations were a hybrid-type procedure (endoscopic andlaparoscopic). While 1 patient required admission to the intensive care unit, there was no mortality in thepostoperative period. The pathological diagnosis was 64.3% (n=9) gastrointestinal stromal tumor, 14.2%(n=2) schwannoma, 7.1% (n=1) leiomyoma, 7.1% (n=1) well–differentiated neuroendocrine tumor, and 7.1%(n=1) enteric cyst. The surgical margin was clear in 92.9% (n=13) of the patients.Conclusion: Resection of benign proximal gastric tumors was successful with laparoscopic endoscopic andopen surgery. In this study, no major morbidity or mortality developed in the postoperative period. Althoughthe superiority to open surgery has not yet been proven with long-term results, the laparoscopic endoscopicmethod should be the first choice due to known advantages, including ease of exploration