Clinical Gastroenterology Vol.30 No.12(3-5)

Theme New Developments in Laparoscopy and Endoscopy Cooperative Surgery (LECS)
Title NEWS (non‒exposed endoscopic wall‒inversion surgery)
Publish Date 2015/11
Author Shinya Kodashima Department of Gastroenterology, Graduate School of Medicine, The University of Tokyo
Author Keiko Niimi Department of Gastroenterology, Graduate School of Medicine, The University of Tokyo / Center for Epidemiology and Preventive Medicine, Graduate School of Medicine, The University of Tokyo
Author Susumu Aikou Department of Gastrointestinal Surgery, Graduate School of Medicine, The University of Tokyo
Author Hiroharu Yamashita Department of Gastrointestinal Surgery, Graduate School of Medicine, The University of Tokyo
Author Mitsuhiro Fujishiro Department of Gastroenterology, Graduate School of Medicine, The University of Tokyo / Department of Endoscopy and Endoscopic Surgery, Graduate School of Medicine, The University of Tokyo
Author Yasuyuki Seto Department of Gastrointestinal Surgery, Graduate School of Medicine, The University of Tokyo
Author Kazuhiko Koike Department of Gastroenterology, Graduate School of Medicine, The University of Tokyo
[ Summary ] Laparoscopy and endoscopy cooperative surgery (LECS) was invented as a minimally invasive full‒thickness resection technique mainly for gastric submucosal tumors. However, this method requires creating a hole in the gastric wall, which confers to patients the risk of intra-abdominal infection. The indication of LECS is limited to submucosal tumors only. Non‒exposed endoscopic wall‒inversion surgery (NEWS) was developed as an endoscopic full‒thickness resection technique without transluminal communication to prevent intra‒abdominal infection or tumor seeding. Therefore, NEWS may be useful to resect gastric submucosal tumors, not only those without ulceration but also those with ulceration, or node‒negative early gastric cancers. Although almost all node‒negative early gastric cancers (EGCs) could be resected by using endoscopic submucosal dissection, we sometimes experience EGCs that are difficult to resect endoscopically because of their location, shape, or submucosal fibrosis. Therefore, NEWS is thought to be effective for EGCs that are difficult to resect by using endoscopic submucosal dissection.
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