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        Non-Exposure Endoscopic-Laparoscopic Cooperative Surgery for Stomach Tumors: First Experience from the Czech Republic

        Jan Hajer,Lukáš Havlůj,Adam Whitley,Robert Gürlich 대한소화기내시경학회 2018 Clinical Endoscopy Vol.51 No.2

        Background/Aims: The aim of this study was to investigate the use of non-exposure endoscopic wall-inversion surgery (NEWS) andthe combination of laparoscopic and endoscopic approaches to neoplasia with non-exposure technique (CLEAN-NET) in gastrictumors. Methods: We reviewed all cases of NEWS and CLEAN-NET performed in the department of surgery of the Royal VinohradyTeaching Hospital. Results: Our department performed 12 gastric tumor resections (NEWS, n=10 and CLEAN-NET, n=2) between March 2016 andFebruary 2017. The cases chosen for these resections included predominantly submucosal tumors with no signs of dissemination orlocal invasion and early gastric carcinomas (T1SM1 and T1M), where tumor location made it impossible to use endoscopic submucosaldissection. R0 resection margins were confirmed in all the cases. Conclusions: NEWS and CLEAN-NET allow en bloc non-exposed full-thickness gastric wall resection in a way that uses a “close first,cut later” approach to prevent seeding of the peritoneal cavity with tumor cells. These mini-invasive techniques combine laparoscopicand endoscopic techniques, and preserve the full function of the stomach.

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