Speakers - CIRWC 2024

Abstract

Objective: To explore the clinical feasibility of Laparoscopic and Endoscopic Cooperative Surgery (LECS) technique applied for the treatment of early gastric cancer.

Methods: We performed the LECS for 16 cases of stage cT1b gastric cancer in Chongqing University Cancer Hospital from January 2021 to October 2023. The cases of 10 males and 6 females ranging from 45 to 78 years (the median age 62), mainly occurred in gastric antrum (9 cases), gastric body (3 cases) and cardia (4 cases). Preoperative biopsy pathological examination and endoscopic ultrasound evaluation were performed and followed by endoscopic submucosal dissection (ESD) and laparoscopic regional lymph node dissection simultaneously. The main observation indexes included intraoperative and pathological features, postoperative factors and follow-up.

Results: ESD and laparoscopic lymph node dissection lasted 35~96 minutes (the median time was 53 minutes) and 50.2±9.3 minutes, respectively, and the median intraoperative blood loss in the latter was 20 ml ranging from 10 to 50 ml. The horizontal and vertical margins were negative in 16 cases, including 5 cases of stage SM1 without lymph node metastasis, and 11 cases of stage SM2. In the 11 cases, one case presented positive regional lymph node and another one hold positive vascular in ESD specimens (negative lymph node), so both performed an additional standard distal gastrectomy and D2 lymphadenectomy, and lymph node metastasis was not found in pathological section samples. In the whole 16 cases, a lymphatic leakage was occurred in one case and cured after conservative treatment; there was no postoperative bleeding, perforation, abdominal infection or incision infection; tumor recurrence or metastasis was not found in the follow-up 6~24 months which the median period was 12 months.

Conclusion: LECS is a safe and practical approach to treating early gastric cancer.