위에 발생한 위장관 간질 종양에서 시행한 복강경 설상절제술과 개복 설상절제술의 비교 = The Comparison between Laparoscopic Wedge Resection and Open Wedge Resection for Gastric Gastrointestinal Stromal Tumors

다국어 초록 (Multilingual Abstract)

Purpose: A laparoscopic wedge resection is increasingly being used for gastrointestinal stromal tumors of the stomach. The aim of this study is to evaluate the safety and the feasibility of laparoscopic wedge resection compared to conventional open wedge resection.
Methods: Fifty-six patients who underwent laparoscopic wedge resection (LW group, n=32) or open wedge resection (OW group, n=24) for gastric submucosal tumor, between January 2005 and December 2007, were enrolled in this retrospective study.
Results: There were no significant differences in the patients` clinicopathological datas between the two groups.
Although there were no significant difference in the operation time and the postoperative morbidity, the time to the first oral intake (1.2±1.5 vs. 1.5±0.6 days, p=0.015), the duration of hospital stay (3.4±0.7 vs. 5.5±0.8 days, p<0.001), and the number of analgesic use (2.2±0.9 vs. 4.0±1.2 times, p ＜0.001) were shorter or lower in the LW group than in the OW group. Among the LW group, three patients with endophytic growth pattern underwent intraoperative gastroduodenoscopy to identify the precise location of the tumor.
Conclusion: Laparoscopic wedge resection is a safe and feasible treatment option for gastrointestinal stromal tumors.
In addition, appropriate approach should be utilized according to the size, the location, and the growth pattern of the tumor.

참고문헌 (Reference)

1 DeMatteo RP, "Two hundred gastrointestinal stromal tumors: recurrence patterns and prognostic factors for survival" 231 : 51-58, 2000

2 Iwahashi M, "Surgical management of small gastrointestinal stromal tumors of the stomach" 30 : 28-35, 2006

3 Novitsky YW, "Long-term outcomes of laparoscopic resection of gastric gastrointestinal stromal tumors" 243 : 738-747, 2006

4 Ishikawa K, "Long-term outcome of laparoscopic wedge resection for gastric submucosal tumor compared with open wedge resection" 16 : 82-85, 2006

5 Mochizuki Y, "Laparoscopic wedge resection for gastrointestinal stromal tumors of the stomach: initial experience" 36 : 341-347, 2006

6 Choi SM, "Laparoscopic wedge resection for gastric" 33 : 444-447, 2007

7 Hwang SH, "Laparoscopic surgery for submucosal tumors located at the esophagogastric junction and the prepylorus" 23 : 1980-1987, 2009

8 Ke ZW, "Laparoscopic resection of submucosal tumor on posterior wall of gastric fundus" 10 : 2850-2853, 2004

9 Aogi K, "Laparoscopic resection of submucosal gastric tumors" 29 : 102-106, 1999

10 Hindmarsh A, "Laparoscopic resection of gastric gastrointestinal stromal tumors" 19 : 1109-1112, 2005

11 Berindoague R, "Laparoscopic resection of clinically suspected gastric stromal tumors" 13 : 231-237, 2006

12 Lukaszczyk JJ, "Laparoscopic resection of benign stromal tumor of the stomach" 2 : 331-334, 1992

13 Hyung WJ, "Laparoscopic resection of a huge intraluminal gastric submucosal tumor located in the anterior wall: eversion method" 89 : 95-98, 2005

14 Basu S, "Gastrointestinal stromal tumors (GIST) and laparoscopic resection" 21 : 1685-1689, 2007

15 Lehnet T, "Gastrointestinal sarcoma (GIST): a review of surgical management" 87 : 297-305, 1998

16 Ro HW, "Effectiveness of laparoscopic resection for gastric submucosal tumors: comparison with Open Resection" 10 : 7-11, 2007

17 Fletcher CD, "Diagnosis of gastrointestinal stromal tumors: a consensus approach" 33 : 459-465, 2002

18 Yang HK, "Clinical experience of laparoscopic wedge resection of stomach" 6 : 33-40, 2003

19 Lee IK, "A clinical analysis of laparoscopic benign gastric tumor resection" 57 : 375-380, 1999