2025, Number 1-4
Hybrid approach for the treatment of a leiomyoma at the gastroesophageal junction: case report
Full text
10.35366/122141
Language: Spanish
References: 13
Page: 18-22
PDF size: 948.56 Kb.
ABSTRACT
Introduction: in recent years, minimally invasive techniques have been developed for the management of tumors in the upper gastrointestinal tract, especially for gastrointestinal stromal tumors (GISTs) that are difficult to access. These techniques aim to improve tumor resection, functionality, and patient recovery time. The hybrid endoscopic-laparoscopic surgery combines the advantages of intraluminal and peritoneal surgery, achieving more precise resections with less morbidity and reduced hospital stays. Clinical case: a 58-year-old female with a history of three cesarean sections and ischemic heart disease. Laboratory studies revealed a slight decrease in hemoglobin (12.2 g/dL) and hematocrit (36.8%), along with positive fecal occult blood. She had no relevant symptoms but was referred to the digestive physiology department. A panendoscopy showed a 2 cm submucosal lesion adjacent to the cardias. A computed tomography scan revealed an 18 mm nodular lesion in the gastric fundus, suggesting a GIST, with no evidence of metastasis. Surgery was scheduled with a preoperative diagnosis of GIST, utilizing a hybrid laparoscopic and endoscopic approach. During surgery, the tumor was located and resected with clear margins, ensuring esophageal permeability and the absence of leaks. The procedure concluded without incidents, and the patient recovered favorably. Conclusion: this case exemplifies how hybrid surgery can be highly beneficial for gastric tumors that occur at the esophagogastric junction which would be difficult to access by purely open, laparoscopic or endoscopic techniques. The hybrid approach allows for resections that maintain oncological and functional outcomes favorable to the patient.REFERENCES
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Lim SG, Hur H, Han S, Lee KM, Kang JK, Shin SJ et al. Laparoscopy-assisted endoscopic full-thickness resection for gastric subepithelial tumors originated from the muscularis propria layer: a pilot study with literature review. Scand J Gastroenterol. 2016; 52: 257-263. doi: 10.1080/00365521.2016.1230778.