Effect of mucosal suture on the healing of mucosal defect in laparoscopic intragastric surgery.
BACKGROUND
The efficacy of mucosal suturing for the healing of a mucosal defect in laparoscopic intragastric surgery (LIGS) for gastric lesions is not yet known.


METHODS
We prospectively studied ten patients who underwent mucosal resection by LIGS for gastric tumors: four patients with early gastric cancer and six with gastric adenoma. Patients were randomly divided into two groups: group I (n = 5); patients who underwent mucosal resection by LIGS with mucosal defect suturing and group II (n = 5); patients who underwent mucosal resection by LIGS without mucosal defect suturing. We performed endoscopy on day 10, and 1 month, 2 months, and 3 months after the operation to observe the healing process of the mucosal defect. The ulcer stage by endoscopy was classified as active, healing, or scarring according to the classification of Sakita and colleagues. Patients were given an H(2)-blocker daily until the mucosal defect improved to the scarring stage.


RESULTS
There were no significant differences in sex, age, tumor location, size of mucosal resection, or the incidence of Helicobacter pylori infection between groups I and II. The ulcer stages in group I were significantly lower than those in group II on day 10, and 1 month, 2 months, and 3 months postoperation. The medication cost (H2-blocker) in group I was significantly lower than that in group II.


CONCLUSIONS
Mucosal defect suturing after mucosal resection by LIGS promotes more rapid healing of mucosal defects and reduces drug costs for patients.
Yumiba
Takeyoshi
T
Department of Surgery, Osaka University Graduate School of Medicine, Osaka, Japan.
Ito
Toshinori
T
Ikushima
Hirofumi
H
Taniguchi
Eiji
E
Inoue
Yoshifumi
Y
Nishida
Toshirou
T
Kitagawa
Toru
T
Nishikawa
Kazuhiro
K
Ohashi
Shuichi
S
Matsuda
Hikaru
H
D000236:Adenoma / Q000503:physiopathology / Q000601:surgery; D000368:Aged; D000897:Anti-Ulcer Agents / Q000627:therapeutic use; D016099:Endoscopy, Gastrointestinal; D005260:Female; D005753:Gastric Mucosa / Q000503:physiopathology / Q000601:surgery*; D006635:Histamine H2 Antagonists / Q000627:therapeutic use; D006801:Humans; D015994:Incidence; D010535:Laparoscopy; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D011183:Postoperative Complications / Q000175:diagnosis / Q000188:drug therapy / Q000503:physiopathology; D011446:Prospective Studies; D016032:Randomized Controlled Trials as Topic; D013274:Stomach Neoplasms / Q000503:physiopathology / Q000601:surgery; D013276:Stomach Ulcer / Q000175:diagnosis / Q000188:drug therapy / Q000503:physiopathology; D013536:Suture Techniques; D013997:Time Factors; D016896:Treatment Outcome; D014945:Wound Healing / Q000502:physiology*
D000897:Anti-Ulcer Agents; D006635:Histamine H2 Antagonists