Francesco Tomba, Arianna Massella, Simone Giacopuzzi, Maria Bencivenga, Carlo Alberto De Pasqual, Angelo Cerofolini, Thomas Togliani,
Giovanni De Manzoni, Luca Rodella
Laparoscopic endoscopic cooperative surgery (LECS) combines laparoscopic gastric resection and endoscopic submucosal dissection for the resection of gastric tumours with minimal and curative resection margins. This approach can also be applied to lower post-operative functional disorders. Classical LECS is safe and feasible for the resection of gastric subepithelial tumours (GIST, NET). LECS can be performed regardless of tumour location and dimensions as opposed to other endoscopic treatments (EFTR, STER). Another benefit is a lower leak rate due to surgical suture. The development of modified non-exposed LECS procedures resolves the risk of abdominal infection and tumour cell seeding in the peritoneum. Recently, patients with gastric epithelial neoplasms have been treated by modified LECS combining the sentinel lymph node mapping technique (SENORITA Trial). The preliminary results are promising in terms of 3-year overall survival. In the future, LECS could be applied to tumour excision in other organs, such as the duodenum, colon rectum.
Tomba F, Massella A, Giacopuzzi S et al. Chirurgia laparoscopica ed endoscopica cooperativa (LECS) per resezioni “a tutto spessore”
del tratto gastrointestinale. GIED. 2022 Dec;vol.4:50-55