title: Surgical Outcomes of Laparoscopic Resection for Subepithelial Lesions on the Gastric Fundus Performed in the Supine or Lateral Decubitus Position.
abstract: BACKGROUND
  Laparoscopic resection of gastric subepithelial lesions (SELs) located on the posterior wall of the gastric fundus is technically difficult and time-consuming. To facilitate access, we propose performing the laparoscopic procedure with patients in a right lateral decubitus position, rather than the standard supine position. The aim of our study was to compare operative and clinical outcomes for laparoscopic SEL resection performed in either the right lateral decubitus or the traditional supine position.
  
  
  METHODS
  The analysis was based on the data of 62 patients who underwent laparoscopic resection of SELs of the gastric fundus at Chonnam National University Hospital: 30 patients in the supine position (SUP) group and 32 in the right lateral decubitus position (RLD) group. All surgeries were performed by a single surgeon. Between-group comparisons were evaluated by Student's t, chi-squared, or Fisher's least squared tests, as appropriate for the data set.
  
  
  RESULTS
  Compared with the SUP group, the RLD had shorter operative time (103 minutes versus 52 minutes, P < .001), less intraoperative blood loss (71 mL versus 31 mL, P < .001), and lower C-reactive protein levels on postoperative days 1 and 2 (P < .005). Time to first flatus and length of hospital stay were comparable between groups.
  
  
  CONCLUSIONS
  Laparoscopic gastric wedge resection for SELs on the gastric fundus in the right lateral decubitus position is feasible and safe, and provides operative advantages over the supine position.
authors.affiliation: Division of Gastroenterologic Surgery, Department of Surgery, Chonnam National University Medical School , Gwangju, Korea.
authors.forename: Ho Goon
authors.initials: HG
authors.lastname: Kim
authors.affiliation: Division of Gastroenterologic Surgery, Department of Surgery, Chonnam National University Medical School , Gwangju, Korea.
authors.forename: Seong Yeob
authors.initials: SY
authors.lastname: Ryu
authors.affiliation: Division of Gastroenterologic Surgery, Department of Surgery, Chonnam National University Medical School , Gwangju, Korea.
authors.forename: Sang Kwon
authors.initials: SK
authors.lastname: Yun
authors.affiliation: Division of Gastroenterologic Surgery, Department of Surgery, Chonnam National University Medical School , Gwangju, Korea.
authors.forename: Dong Yi
authors.initials: DY
authors.lastname: Kim
mesh_terms: D000328:Adult; D000368:Aged; D005260:Female; D005743:Gastrectomy / Q000009:adverse effects / Q000379:methods*; D005748:Gastric Fundus / Q000473:pathology* / Q000601:surgery; D006801:Humans; D010535:Laparoscopy / Q000009:adverse effects / Q000379:methods*; D007902:Length of Stay / Q000706:statistics & numerical data; D008297:Male; D008875:Middle Aged; D061646:Operative Time; D056888:Patient Positioning / Q000379:methods*; D011183:Postoperative Complications / Q000453:epidemiology; D012189:Retrospective Studies; D013274:Stomach Neoplasms / Q000601:surgery*; D016896:Treatment Outcome
keywords: laparoscopy; outcomes; subepithelial lesion