Matsuyama Takatoshi, Izumi Yosuke, Ito Tetsuya, Tokita Hiromi, Iwao Yasuhito, Nishida Kiyotaka, Sakamoto Kentaro, Hosokawa Takashi, Chika Noriyasu, Kakimoto Masaki, Park Sonjin, Yoshimura Tetsunori, Koshiishi Haruya, Okamura Takashi
Dept. of Surgery, Tokyo Metropolitan Ohtsuka Hospital.
Gan To Kagaku Ryoho. 2010 Nov;37(12):2445-7.
We report a case of patient who underwent resection for local recurrent gastric cancer at the anastomotic site curatively. The patient was a 72 years old male with a history of undergoing total gastrectomy for gastric cancer located at the gastric cardia in February 2005. The histological findings of the resected tumor showed a Type 3 advanced gastric cancer invaded into subserosa in the cardia of the stomach with positive lymphatic and venous invasion and lymph node metastasis. The histological diagnosis was moderately differentiated tubular adenocarcinoma. Both the proximal and distal margins were negative for cancer. Endoscopy, 4 years after the first operation, showed a recurrent tumor at the site of esophago-jejunal anastomosis. A resection of the tumor was carried out curatively through the left thoraco-abdominal approach in June 2009. We recommend a resection of anastomotic recurrence especially if it occurs from the first operation in the long interval.
我们报告一例因局部复发性胃癌在吻合口处接受根治性切除的患者。该患者为72岁男性，有2005年2月因贲门部胃癌接受全胃切除术的病史。切除肿瘤的组织学检查结果显示为3型进展期胃癌，侵犯胃贲门部浆膜下层，伴有淋巴管和静脉侵犯及淋巴结转移。组织学诊断为中分化管状腺癌。切缘近端和远端均无癌转移。首次手术后4年，内镜检查显示食管空肠吻合口处有复发性肿瘤。2009年6月通过左胸腹联合入路对肿瘤进行了根治性切除。我们建议对吻合口复发进行切除，特别是如果复发发生在首次手术后较长时间间隔时。
