Laparoscopic-endoscopic rendezvous resection of upper gastrointestinal tumors

Abstract

Background: Endoscopic and laparoscopic local resection of gastric tumors has increasingly been performed in recent years. This article describes the technical considerations and early results of laparoscopic-endoscopic rendezvous resection of gastric lesions.

Patients and methods: Rendezvous resection was performed in 26 patients with submucosal gastric tumors (n = 22) and early gastric cancer (n = 4). Laparoscopic wedge resection (LWR) was performed in 16 patients with anterior wall tumors and laparoscopic intragastric resection (LIR) in 7 patients with posterior wall tumors. Conversion to open surgery was carried out in 3 cases.

Results: Operation times were 53 min (range 35-115) for LWR and 83 min (range 56-130) for LIR, respectively. In submucosal lesions the mean tumor size was 36 mm (range 16-47) and in early gastric cancer 17.3 mm (range 16-20). Rendezvous resection was performed with curative intent and clear resection margins in all patients without lymphatic or vessel permeation. Postoperative complications occurred in 2 patients. After a mean follow-up of 22.8 months (range 2-71), no local recurrence or metastatic disease and no tumor-related death were observed.

Conclusions: When selected properly, the laparoscopic-endoscopic approach is considered to be curative and safe for resection of localized gastric tumors.