Laparoendoscopic Gastric Surgery The laparoendoscopic local resection of benign gastric tumors and early gastric cancer is increasingly performed during the last years. Until December 2003 61 patients were operated on laparoscopically for benign submucosal tumors (n = 45) or early gastric cancer (n = 16) in our two centers. Laparoscopic wedge resection (LVR), intragastric resection (LIR) and extramucosal enucleations (LER) were performed in 28, 24 and 9 patients, respectively. In submucosal lesions the mean size of the tumor was 3.6 cm (range 0.8–6.7 cm) and in early gastric cancer 1.1 cm (0.3–2.3 cm). Operation times for LVR, LIR and LER were 42.7 min (31–72 min), 69.5 min (49–112 min) and 63.2 min (35–110 min), respectively. Both intraand postoperative complications occurred in 4.9% of the cases. There were two conversions to open surgery, and two repeat laparoscopic procedures were necessary. Two patients required open second-step resections for poorly diffentiated GISTs. In all patients, the surgical margins in the primary specimens were tumor-free without lymphatic or venous invasion. There were no tumor recurrences or tumor-related deaths during a mean follow-up period of 31.6 months (5–84 months) for early gastric cancer or 28.2 months (1–87 months) for GISTs. Tumor type and localization determine the decision for a certain technique within the spectrum of gastric laparoendoscopic approaches.

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