Laparoscopic resection of posterior gastric wall leiomyoma: a case report

Abstract

Leiomyoma of the stomach is an uncommon lesion and represents 1% of all gastric neoplasms. Because of the stomach's size, mobility and distensibility, benign and malignant gastric diseases can be safely excised with laparoscopic wedge resection. A 70- year- old woman referred to our hospital with a history of epigastric pain, dyspepsia and gastrointestinal bleeding. Preoperative upper gastrointestinal endoscopy and computed tomographic scan revealed, just below the fundus on the posterior wall of the stomach, an exophytic tumor extending to the spleen, with a measuring 4 cm in diameter. Endoscopic biopsies were not obtained because of the risk of bleeding. The tumor was resected with a 3-cm margin using stapling device by laparoscopic procedure. Pathologic examination revealed a leiomyoma. Several approaches to the resection of gastric lesions have been utilized, depending on the location of the lesion. Wedge resection is optimal for exophytic lesions on the anterior or posterior surface of the stomach. Local resection of the leiomyoma of stomach with disease-free resection margins is sufficient. Recent advances in laparoscopic surgery have allowed this approach to be applied to gastric surgery. Stapled laparoscopic resection is a safe and effective treatment option for gastric leiomyoma.