Benign Esophageal and Gastric Tumors: Laparoscopic Management of Benign Submucosal Tumors
Benign submucosal tumors in the proximal GI tract are rare and often asymptomatic. The majority of these tumors are leiomyomas in the esophagus and gastrointestinal stromal tumors in the stomach. While surveillance is a viable option, symptomatic tumors, or those with worrisome characteristics, should be excised. The operative goal is complete resection without altering gastrointestinal function. The surgical approach and technique are dependent on the location of the tumor and whether resection may overly narrow the intestinal lumen (i.e., near the pylorus) or injure nearby structures. Preoperative or intraoperative upper endoscopy can be invaluable to assist in tumor localization. More recently, hybrid laparoscopic and endoscopic submucosal dissection has shown promise in achieving less radical dissections and perhaps avoiding the need for major reconstruction (i.e., Billroth I/II, Roux-en-Y) after the tumor is excised. These techniques are gaining popularity as endoscopic surgery is becoming more commonplace; however, the large studies addressing safety and efficacy are lacking.
KeywordsSubmucosal Benign Gastric Tumors Laparoscopic Endoscopy Resection
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