[Novel approach to laparoscopy and endoscopy cooperative surgery (LECS) in gastric submucosal tumors near the esophago-gastric junction].

BACKGROUND AND PURPOSE: Laparoscopy and endoscopy cooperative surgery (LECS) for gastric submucosal tumors is an excellent surgical procedure that enables prevention of excessive resection and deformity of the stomach. This procedure may be more useful for gastric submucosal tumors near the esophagogastric (EG) junction and the pylorus. We present a novel approach to LECS for gastric submucosal tumors near the EG junction. PATIENTS: From 2010 to 2013, seven consecutive patients underwent LECS for gastric submocosal tumors near the EG junction. Novel approach: Our novel approach to LECS involved (1) minimizing the resection of the stomach wall by using endoscopic mucosal resection for all types of submucosal tumor, (2) selecting the best anastomotic axis in order to avoid deformity of the stomach, (3) using hand sewing if anastomotic complications might occur and (4) sometimes combining anti-reflux surgery with LECS for tumors extremely close to the EG junction. RESULTS: No patient had any anastomotic complications or reflux esophagitis. CONCLUSIONS: LECS is safe and useful for gastric submucosal tumors near the EG junction.