Laparoscopic Wedge Resection with Hand-Sewing Closure for Gastroduodenal Tumors.
- Author:
Joo Ho LEE
1
;
Seog Ki MIN
;
Young Woo KIM
;
Hyeon Kook LEE
;
Ho Seong HAN
Author Information
1. Department of Surgery, Ewha Womans University College of Medicine, Seoul, Korea. hans@ewha.ac.kr
- Publication Type:Original Article
- Keywords:
Laparoscopic wedge resection;
Hand-sewing closure;
Gastroduodenal tumor
- MeSH:
Adenoma;
Adenomyoma;
Carcinoid Tumor;
Conversion to Open Surgery;
Diagnosis;
Eating;
Electrocoagulation;
Eosinophilic Granuloma;
Female;
Gastrointestinal Stromal Tumors;
Humans;
Hyperplasia;
Leiomyoma;
Length of Stay;
Pancreas;
Postoperative Complications;
Running;
Stomach Neoplasms;
Surgical Instruments;
Sutures;
Ultrasonics
- From:Journal of the Korean Surgical Society
2003;64(6):466-470
- CountryRepublic of Korea
- Language:Korean
-
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.
