Abstract
Leiomyoma of the stomach is an uncommon lesion and represents 1% of all gastric neoplasms. Because of the stomach's size, mobility and distensibility, benign and malignant gastric diseases can be safely excised with laparoscopic wedge resection. A 70- year- old woman referred to our hospital with a history of epigastric pain, dyspepsia and gastrointestinal bleeding. Preoperative upper gastrointestinal endoscopy and computed tomographic scan revealed, just below the fundus on the posterior wall of the stomach, an exophytic tumor extending to the spleen, with a measuring 4 cm in diameter. Endoscopic biopsies were not obtained because of the risk of bleeding. The tumor was resected with a 3-cm margin using stapling device by laparoscopic procedure. Pathologic examination revealed a leiomyoma. Several approaches to the resection of gastric lesions have been utilized, depending on the location of the lesion. Wedge resection is optimal for exophytic lesions on the anterior or posterior surface of the stomach. Local resection of the leiomyoma of stomach with disease-free resection margins is sufficient. Recent advances in laparoscopic surgery have allowed this approach to be applied to gastric surgery. Stapled laparoscopic resection is a safe and effective treatment option for gastric leiomyoma.
Keywords:
Gastric leiomyoma, laparoscopy, gastric surgery
References
1Ibrahim IM, Silvestri F, Zingler B. Laparoscopic resection of posterior gastric leiomyoma: case reports. Surg Endosc 1997; 11: 277–279.
2Akwari OE. Benign tumors of the stomach. In: Sabiston DC (ed) Textbook of surgery. W.B. Saunders, Philadelphia, 1991; P pp 790– 791.
3Choi YB, Oh ST. Laparoscopy in the management of gastric submucosal tumors. Surg Endosc 2000; 14: 741-745
4Cuschieri A. Laparoscopic gastric resection. Surg Clin North Am 2000; 80: 1269- 1284
5Hepworth CC, Menzies D, Motson RW. Minimally invasive surgery for posterior gastric stromal tumors. Surg Endosc 2000; 14: 349-353
6Bouillot J, Bresler L, Louis P, Samama G. Laparoscopic resection of benign submucosal gastric tumors: A report of 65 cases. Gastroenterol Clin Biol 2003; 27: 272-276
7Rothlin M, Schob O. Laparoscopic wedge resection for benign gastric tumors. Surg Endosc 2001; 15: 893-895
8Walsh RM, Heniford BT. Laparoendoscopic treatment of gastric stromal tumors. Semin Laparosc Surg 2001; 8: 189-194
9Tangoku A, Yamamoto K, Hirazawa K, Takao T, Mori N, Tada K, Oka M. Laparoscopic resection of large leiomyomas of the gastric fundus. Surg Endosc 1999; 13: 1050–1052.
10DeMatteo RP, Lewis JJ, Leung D, Mudan SS, Woodruff JM, Brennan MF. Two hundred gastrointestinal stromal tumors: recurrence patterns and prognostic factors for survival. Ann Surg 2000; 231:51-58.