Lee Sangjun, Min Sa-Hong, Park Ki Bum, Kim Dong-Wook, Lee Yoontaek, Park Young Suk, Ahn Sang-Hoon, Park Do Joong, Kim Hyung-Ho
Department of Surgery, Seoul National University Bundang Hospital, Seongnam, Korea.
Department of Surgery, Kyungpook National University Hospital, Daegu, Korea.
J Minim Invasive Surg. 2019 Sep 15;22(3):106-112. doi: 10.7602/jmis.2019.22.3.106.
The standard treatment for gastric subepithelial tumor (SET) is surgical resection, which is primarily performed via laparoscopy. The aims of this study were firstly to evaluate factors influencing morbidity and hospitalization after treatment of gastric SET, and secondly, to figure out the factors how to make shorter hospitalization with equal safety.
We retrospectively enrolled 229 consecutive patients who underwent laparoscopic gastric wedge resection (LGWR) for gastric SET between August 2003 and December 2015. Patients were divided into two groups: the 3 days or less hospitalization group (N=82, group A) and the greater than 3 days hospitalization group (N=147, group B).
Median tumor size was 3.0 cm (range, 0.2~13.0 cm) and mean postoperative hospitalization was 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, <0.01) and more likely to be located on the greater curvature (28% vs. 15%, <0.01) compared with group B. The tumor growth pattern (exophytic tumor: 72% in group A vs. 65% in group B, =0.25) was not different between the two groups. Multivariate analysis showed that tumor size larger than 5 cm and posterior wall tumor location were risk factors for longer hospital stay.
We could reduce the hospitalization of patients with gastric SET less than 5cm sized and located on other than the posterior wall within 3days. Those patients could be a candidate for day surgery.
胃上皮下肿瘤（SET）的标准治疗方法是手术切除，主要通过腹腔镜进行。本研究的目的，一是评估影响胃SET治疗后发病率和住院时间的因素，二是找出在同等安全性下缩短住院时间的因素。
我们回顾性纳入了2003年8月至2015年12月期间连续接受腹腔镜胃楔形切除术（LGWR）治疗胃SET的229例患者。患者分为两组：住院时间3天及以内组（N = 82，A组）和住院时间大于3天组（N = 147，B组）。
肿瘤中位大小为3.0 cm（范围0.2~13.0 cm），术后平均住院时间为4.27±2.15天。有6例并发症（2.6%），无死亡病例。与B组相比，A组肿瘤较小（3.0±1.1 cm对3.6±1.9 cm，<0.01），且更可能位于大弯侧（28%对15%，<0.01）。两组间肿瘤生长方式（外生性肿瘤：A组72%，B组65%，P = 0.25）无差异。多因素分析显示，肿瘤大小大于5 cm和肿瘤位于后壁是住院时间延长的危险因素。
我们可以将胃SET大小小于5 cm且位于非后壁的患者的住院时间缩短至3天以内。这些患者可以作为日间手术的候选对象。
