Laparoscopic-Endoscopic Rendezvous Resection of Upper Gastrointestinal Tumors

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Abstract
Background: Endoscopic and laparoscopic local resection of gastric tumors has increasingly been performed in recent years. This article describes the technical considerations and early results of laparoscopic-endoscopic rendezvous resection of gastric lesions. Patients and Methods: Rendezvous resection was performed in 26 patients with submucosal gastric tumors (n = 22) and early gastric cancer (n = 4). Laparoscopic wedge resection (LWR) was performed in 16 patients with anterior wall tumors and laparoscopic intragastric resection (LIR) in 7 patients with posterior wall tumors. Conversion to open surgery was carried out in 3 cases. Results: Operation times were 53 min (range 35–115) for LWR and 83 min (range 56–130) for LIR, respectively. In submucosal lesions the mean tumor size was 36 mm (range 16–47) and in early gastric cancer 17.3 mm (range 16–20). Rendezvous resection was performed with curative intent and clear resection margins in all patients without lymphatic or vessel permeation. Postoperative complications occurred in 2 patients. After a mean follow-up of 22.8 months (range 2–71), no local recurrence or metastatic disease and no tumor-related death were observed. Conclusions: When selected properly, the laparoscopic-endoscopic approach is considered to be curative and safe for resection of localized gastric tumors.