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Laparoscopic Treatment of Gastric Subepithelial Tumor: Finding Ways to Manage with Shorter Hospitalization Days

Journal of Minimally Invasive Surgery 2019년 22권 3호 p.106 ~ 112
 ( Lee Sang-Jun ) - Seoul National University Bundang Hospital Department of Surgery

 ( Min Sa-Hong ) - Seoul National University Bundang Hospital Department of Surgery
 ( Park Ki-Bum ) - Kyungpook National University Hospital Department of Surgery
 ( Kim Dong-Wook ) - Dankook University Hospital Department of Surgery
 ( Lee Yoon-Taek ) - Ehwa University Medical Center Department of Surgery
 ( Park Young-Suk ) - Seoul National University Bundang Hospital Department of Surgery
 ( Ahn Sang-Hoon ) - Seoul National University Bundang Hospital Department of Surgery
 ( Park Do-Joong ) - Seoul National University Bundang Hospital Department of Surgery
 ( Kim Hyung-Ho ) - Seoul National University Bundang Hospital Department of Surgery

Abstract


Purpose: The standard treatment for gastric subepithelial tumor (SET) is surgical resection, which isprimarily performed via laparoscopy. The aims of this study were firstly to evaluate factorsinfluencing morbidity and hospitalization after treatment of gastric SET, and secondly, to figure outthe factors how to make shorter hospitalization with equal safety.

Methods: We retrospectively enrolled 229 consecutive patients who underwent laparoscopic gastricwedge resection (LGWR) for gastric SET between August 2003 and December 2015. Patients weredivided into two groups: the 3 days or less hospitalization group (N=82, group A) and the greater than3 days hospitalization group (N=147, group B).

Results: Median tumor size was 3.0 cm (range, 0.2~13.0 cm) and mean postoperative hospitalizationwas 4.27±2.15 days. There were 6 complications (2.6%), with no cases of mortality. In group A,tumors were smaller (3.0±1.1 cm vs. 3.6±1.9 cm, p<0.01) and more likely to be located on the greatercurvature (28% vs. 15%, p<0.01) compared with group B. The tumor growth pattern (exophytic tumor:72% in group A vs. 65% in group B, p=0.25) was not different between the two groups. Multivariateanalysis showed that tumor size larger than 5 cm and posterior wall tumor location were risk factorsfor longer hospital stay.

Conclusion: We could reduce the hospitalization of patients with gastric SET less than 5 cm sized andlocated on other than the posterior wall within 3 days. Those patients could be a candidate for daysurgery.

키워드

Laparoscopy; Gastrectomy; Day surgery; Subepithelial
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