위십이지장 종양에 대한 복강경 설상절제와 수기봉합술

• Published in: Annals of surgical treatment and research Vol. 64; no. 6; pp. 466 - 470
• Main Authors: 이주호(Joo-Ho Lee), 민석기(Seog-Ki Min), 김영우(Young-Woo Kim), 이현국(Hyeon-Kook Lee), 한호성(Ho-Seong Han)
• Format: Journal Article
• Language: Korean
• Published: 대한외과학회 01.06.2003
• Subjects: 일반외과학
• ISSN: 2288-6575; 2288-6796

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. (J Korean Surg Soc 2003;64:466-470) KCI Citation Count: 0