Because these two lesions were resected as a single specimen, the lesions were handled and examined as one case. Sentinel lymph node biopsy was performed in the patient with a carcinoid tumor. The biopsy revealed no lymph node metastasis in the patient. Two patients with clinically relevant gastric dysfunction had GISTs located in the lesser curvature of the stomach. The major axis of these two tumors was 34 mm and 38 mm. Although these two patients with clinically relevant gastric dysfunction had uneventful postoperative courses, their postoperative hospital stays were longer than those of patients without clinically relevant gastric dysfunction. In our medical institution, LECS is performed mainly in patients with SMTs with intraluminal growth. Because LECS opens the stomach wall, resulting in scattering of the gastric contents Ergosterol around the abdominal cavity, this surgical technique is contraindicated in patients with ulceration or tumor exposure in the cupulate part of an SMT because of the possibility of dissemination. According to the Japan Society of Clinical Oncology Clinical Practice Guidelines for GIST, LECS may be indicated for SMTs with diameters of #5 cm. In the present series, LECS was performed in 22 patients with SMTs. None of the patients required discontinuation of LECS and conversion to open abdominal 
surgery. Additionally, there were no postoperative complications other than gastric motility disorder. Therefore, we consider LECS to be a safe and useful treatment method. Very few studies have evaluated residual gastric motility after local resection of the stomach. Most of the patients in these studies had favorable postoperative gastric motility, but some had reduced dietary intake because of Anemarsaponin-BIII epigastric symptoms. Tsujimoto et al reported that of 20 patients who underwent LECS, none developed malnutrition. Additionally, postoperative endoscopy revealed no evidence of gastric motility disorder, such as food residue or reflux esophagitis. However, that study included only two patients with lesions located in the lesser curvature, and the authors did not provide a detailed description of the postoperative symptoms. Kang et al reported that of 101 patients who underwent LECS, none of the patients with preservation of the cardia and pylorus experienced postoperative epigastric symptoms. However, that study included operative methods such as distal gastrectomy and proximal gastrectomy other than local resection; additionally, postoperative gastric motility was not evaluated by examination techniques such as endoscopy. In our study, clinically relevant gastric motility disorder occurred in two of the four patients with tumors of the lesser curvature, but did not occur in any of the patients with tumors located in other areas of the stomach. Therefore we consider the possibility that resection of tumors in the lesser curvature may lead to gastric motility disorder. We believe that a potential influence on gastric motility after LECS is resection of Latarjet’s branch of the vagal nerve and gastric deformity. Kubota et al performed local gastric resection of either the lesser or the greater curvature in dogs and physiologically evaluated postoperative residual gastric motility. The authors reported that resection of the lesser curvature involves resection of Latarjet’s branch of the vagal nerve, which is distributed in the lesser curvature.