Transgastric surgery for XXXX : a minimal and safe approach.

@entity1 @entity548 @entity5 @entity1457 @entity1066 @entity360
HYPOTHESIS: A transgastric approach may be used succesfully for the treatment of @entity1066 presenting with @entity548 . METHODS: Eight @entity1 were admitted during a 6-year period with acute massive @entity360 caused by @entity1066 . All @entity1 had signs of profound @entity1457 , and initial endoscopic control was achieved in 3 @entity1 . They all underwent surgery after endoscopy. At operation, the @entity1066 was approached through an anteromedial gastrostomy and hemostasis was achieved by transfixing stitches. Ulcers were excised whenever possible, or excluded if adherent posteriorly. Four-quadrant biopsy was taken for frozen section to exclude @entity5 . Both anterior and posterior gastric walls were then closed with nonabsorbable suture material. RESULTS: There were 6 @entity1 and 2 @entity1 with a mean age of 73 years. Hemoglobin levels ranged from 5.2 to 8.0 g/dL. Five @entity1 underwent emergency surgery within 28 hours of admission. The diameter of the @entity1066 ranged from 2 to 5 cm. Ulcerectomy was performed in 6 cases. In the remaining 2 @entity1 , the crater of the @entity1066 was adherent to the diaphragm and required exclusion from the gastrointestinal tract. None of the @entity1066 proved to be malignant, and there were no operative deaths. @entity1 were followed up for a mean of 3 years with no complications. CONCLUSIONS: Satisfactory results can be achieved with a transgastric approach to these rare @entity1066 . This allows definitive treatment while avoiding major gastric resection with its potential complications.
