Oh Dong-Hyeon, Park Yong-Eun, Kim Sang-Woon, Bae Jung-Min
Department of Surgery, Yeungnam University Medical Center, Daegu, Korea.
Yeungnam University College of Medicine, Daegu, Korea.
J Minim Invasive Surg. 2020 Sep 15;23(3):139-143. doi: 10.7602/jmis.2020.23.3.139.
Gastric subepithelial tumor (GST) is a disease entity that includes all gastric subepithelial lesions. The oncologically safe surgical technique is complete resection with adequate resection margins. Most of the studies about laparoscopic gastric wedge rsection (LGWR) in GST focus on oncologic curability or surgical effectiveness. However, studies on the factors associated with the operation time are rare. Therefore, this study was conducted to analyze and compare the factors associated with the operation time of LGWR.
From 2010 to 2019, 145 consecutive patients undergoing LGWR were reviewed retrospectively. Clinical characteristics of GST and operation time were analyzed and compared.
A total of 145 patients was enrolled and reviewed. There were 59 males (40.7%) and 86 females (59.3%) with a mean age of 53.6 years and mean body mass index (BMI) of 23.9 kg/m2. Mean tumor size was 2.9 cm and mean operation time was 66.0 minutes. In statistically, the mean operation time showed significant association with tumor size, BMI, longitudinal tumor location and tumor location between lesser and greater curvature. In multivariate analysis, tumor size, BMI and longitudinal classification of tumor location are statistically significant.
A shorter operation time is expected when there is a small tumor, low BMI and mid portion of the stomach GST. Preoperative evaluation for tumor size and body weight is important. In patients with large GST, obesity and both end stomach GST, we think that pre-operative preparation for long operation time should be considered.
胃上皮下肿瘤（GST）是一种涵盖所有胃上皮下病变的疾病实体。肿瘤学上安全的手术技术是进行完整切除并保证足够的切缘。大多数关于腹腔镜胃楔形切除术（LGWR）治疗GST的研究都集中在肿瘤学可治愈性或手术效果上。然而，关于与手术时间相关因素的研究却很少。因此，本研究旨在分析和比较与LGWR手术时间相关的因素。
回顾性分析2010年至2019年连续接受LGWR的145例患者。分析并比较GST的临床特征和手术时间。
共纳入并回顾了145例患者。其中男性59例（40.7%），女性86例（59.3%），平均年龄53.6岁，平均体重指数（BMI）为23.9kg/m²。平均肿瘤大小为2.9cm，平均手术时间为66.0分钟。统计学上，平均手术时间与肿瘤大小、BMI、肿瘤纵向位置以及小弯和大弯之间的肿瘤位置存在显著关联。多因素分析显示，肿瘤大小、BMI和肿瘤位置的纵向分类具有统计学意义。
当肿瘤较小、BMI较低且为胃中部GST时，预计手术时间较短。术前评估肿瘤大小和体重很重要。对于GST较大、肥胖以及胃两端GST的患者，我们认为应考虑为长时间手术进行术前准备。
