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腹腔镜下残胃癌根治性全胃切除术:两例手术技巧及经验

Laparoscopic completion total gastrectomy in remnant gastric cancer: technical detail and experience of two cases.

作者信息

Song Jyewon, Kim Jeong Yoen, Kim Sungsoo, Choi Won Hyuk, Cheong Jae Ho, Hyung Woo Jin, Choi Seung Ho, Noh Sung Hoon

机构信息

Department of Surgery, Yonsei University College of Medicine, Seoul, Korea.

出版信息

Hepatogastroenterology. 2009 Jul-Aug;56(93):1249-52.

Abstract

The treatment of choice for remnant gastric cancer is resection by open conventional method, but due to adhesion and deformed anatomic structure, reoperation is one of the most complicated surgeries. We therefore introduce 2 cases of laparoscopy-assisted completion total gastrectomy. One was 67 yrs old male who had radical subtotal gastrectomy with gastrojejunostomy due to stomach cancer 30 years ago. Gastric polyp was found in routine EGD. Biopsy results showed focal adenocarcinoma and laparoscopy-assisted total gastrectomy with Roux-en-Y esophagojejunostomy was decided and performed. The other case was 65 yrs old male who went through radical subtotal gastrectomy with gastroduodenostomy 8 years ago due to stomach cancer. Recur was diagnosed by routine EGD, and laparoscopic assisted total gastrectomy with Roux-en-Y esophagojejunostomy was done. As can be seen in this study, laparoscopy-assisted gastrectomy could be safely applied in remnant gastric cancer.

摘要

残胃癌的首选治疗方法是采用传统开放手术进行切除,但由于粘连和解剖结构变形,再次手术是最复杂的手术之一。因此,我们介绍2例腹腔镜辅助完全性全胃切除术。1例为67岁男性,30年前因胃癌行根治性胃大部切除术并胃空肠吻合术。在常规胃镜检查中发现胃息肉。活检结果显示为局灶性腺癌,遂决定并实施腹腔镜辅助全胃切除术及 Roux-en-Y 食管空肠吻合术。另一例为65岁男性,8年前因胃癌行根治性胃大部切除术并胃十二指肠吻合术。经常规胃镜检查诊断为复发,遂行腹腔镜辅助全胃切除术及 Roux-en-Y 食管空肠吻合术。从本研究可以看出,腹腔镜辅助胃切除术可安全应用于残胃癌。

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