위십이지장 종양에 대한 복강경 설상절제와 수기봉합술
Laparoscopic Wedge Resection with Hand-Sewing Closure for Gastroduodenal Tumors
소속 상세정보
이주호/Joo Ho Lee
민석기/김영우/이현국/한호성/Seog Ki Min/Young Woo Kim/Hyeon Kook Lee/Ho Seong Han
KMID : 0371320030640060466
Abstract
PURPOSE: To evaluate the feasibility and efficacy of a laparoscopic wedge resection with hand-sewing closure in gastroduodenal tumors. METHODS: Laparoscopic wedge resections were performed in 16 patients with gastroduodenal tumors between May 2000 and
December 2002 at Ewha Womans University Mok-Dong Hospital. Every case, with the exception of one, was performed via an extragastric approach, with a transgastric approach performed in the exception. Excision of lesion was performed manually using
electrocautery and ultrasonic coagulating shears and closed by a manual (not use autosuture stapler) intracoporeal running suture. RESULTS: Of the 16 cases, two were performed with a laparoscope-assisted method, but there were no conversion to open
surgery. Mean size of lesions was 27.9 mm in diameter and mean operation time was 219 minutes. In all cases, a complete tumor excision with negative surgical margins was obtained. The final pathologic diagnoses were: ectopic pancreas 4 cases,
gastrointestinal stromal tumor 3 cases, leiomyoma 2 cases, adenomyoma 2 cases, tubular adenoma 1 case, Brunner's gland hyperplasia 1 case, carcinoid tumor 1 case, eosinophilic granuloma 1 case, and post endoscopic mucosectomy state for early gastric
cancer 1 case. The average number of days to the first postoperative oral food intake and hospital stay were 3.1 and 6.0 days, respectively. There were no postoperative complications. CONCLUSION: A laparoscopic wedge resection with hand- sewing closure
should be considered as a valid treatment option for selected gastroduodenal tumors, in terms of its feasibility, safety, and cost. A more efficient surgical instrument and technique should be developed in the future.
키워드
복강경 설상절제; 수기봉합; 위십이지장 종양; Laparoscopic wedge resection; Hand-sewing closure; Gastroduodenal tumor;
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