Department of Surgery, Incheon St. Mary's Hospital, The Catholic University of Korea, School of Medicine, Incheon, Korea.
J Gastric Cancer. 2011 Jun;11(2):131-4. doi: 10.5230/jgc.2011.11.2.131. Epub 2011 Jun 30.
A laparoscopic wedge resection for a submucosal tumor, which is close to the gastroesophageal junction, is technically challenging. This can be a dilemma to both patients and surgeons when the tumor margin involves the gastroesophageal junction because a wedge resection in this situation might result in a deformity of the gastroesophageal junction or an injury to the lower esophageal sphincter, which ultimately results in lifelong gastroesophageal reflux disease. The patient was a 42 year-old male, whose preoperative endoscopic ultrasonographic finding did not rule out a gastrointestinal stromal tumor. He underwent a laparoscopic gastric wedge resection and prophylactic anterior partial fundoplication (Dor) and was discharged from hospital on the fifth postoperative day without any complications. There were no symptoms of reflux 5 months after surgery. A laparoscopic wedge resection and prophylactic anti-reflux surgery might be a good surgical option for a submucosal tumor at the gastroesophageal junction.
胃食管结合部黏膜下肿瘤行腹腔镜楔形切除术具有一定难度。当肿瘤边缘累及胃食管结合部时,患者和外科医生可能会陷入两难的境地,因为在这种情况下行楔形切除术可能会导致胃食管结合部变形或损伤下食管括约肌,最终导致终身胃食管反流病。该患者为 42 岁男性,术前内镜超声检查结果不能排除胃肠道间质瘤。患者接受了腹腔镜胃楔形切除术和预防性前部分胃底折叠术(Dor),术后第 5 天出院,无任何并发症。术后 5 个月无反流症状。对于胃食管结合部黏膜下肿瘤,腹腔镜楔形切除术和预防性抗反流手术可能是一种较好的手术选择。