Clinical Endoscopy

The Korean Society of Gastrointestinal Endoscopy (대한소화기내시경학회)
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Non-Exposure Endoscopic-Laparoscopic Cooperative Surgery for Stomach Tumors: First Experience from the Czech Republic

  • Hajer, Jan (Second Department of Internal Medicine, Third Faculty of Medicine and University Hospital Kralovske Vinohrady, Charles University) ;
  • Havluj, Lukas (Department of General Surgery, Third Faculty of Medicine and University Hospital Kralovske Vinohrady, Charles University) ;
  • Whitley, Adam (Department of General Surgery, Third Faculty of Medicine and University Hospital Kralovske Vinohrady, Charles University) ;
  • Gurlich, Robert (Department of General Surgery, Third Faculty of Medicine and University Hospital Kralovske Vinohrady, Charles University)
  • Received : 2017.05.15
  • Accepted : 2017.08.24
  • Published : 2018.03.30
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Abstract

Background/Aims: The aim of this study was to investigate the use of non-exposure endoscopic wall-inversion surgery (NEWS) and the combination of laparoscopic and endoscopic approaches to neoplasia with non-exposure technique (CLEAN-NET) in gastric tumors. Methods: We reviewed all cases of NEWS and CLEAN-NET performed in the department of surgery of the Royal Vinohrady Teaching Hospital. Results: Our department performed 12 gastric tumor resections (NEWS, n=10 and CLEAN-NET, n=2) between March 2016 and February 2017. The cases chosen for these resections included predominantly submucosal tumors with no signs of dissemination or local invasion and early gastric carcinomas ($T1_{SM1}$ and $T1_M$), where tumor location made it impossible to use endoscopic submucosal dissection. R0 resection margins were confirmed in all the cases. Conclusions: NEWS and CLEAN-NET allow en bloc non-exposed full-thickness gastric wall resection in a way that uses a "close first, cut later" approach to prevent seeding of the peritoneal cavity with tumor cells. These mini-invasive techniques combine laparoscopic and endoscopic techniques, and preserve the full function of the stomach.

Keywords

Acknowledgement

Supported by : Charles University

References

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