Department of Surgery, Machida Municipal Hospital, 2-15-41 Asahicho, Machida, Tokyo, Japan.
Langenbecks Arch Surg. 2013 Feb;398(2):341-5. doi: 10.1007/s00423-012-0979-8. Epub 2012 Jul 10.
In patients having carcinoma in the remnant stomach, total resection of the remnant stomach with lymph node dissection is a prerequisite.
We present the first series of successful totally laparoscopic complete gastrectomy (TLCG) for gastric remnant cancer.
TLCG was successfully performed without adverse events during surgery in five patients with gastric remnant cancer. The median age of the patients was 72 years (range, 56-84 years), and there were three men and two women. Three of them had a Billroth I reconstruction and two had a Billroth II reconstruction, and in four cases following partial gastrectomy for gastric cancer and one for gastroduodenal ulcer. The median operative time was 360 min; blood loss was 20 ml. The median number of retrieved lymph nodes was 19. No complications occurred postoperatively, and all of the patients were discharged within the ninth postoperative day.
Although TLCG for gastric remnant cancer is a technically difficult and challenging operation that requires careful lysis of adhesion and dissection along the major vessels, as well as intracorporeal anastomosis, this procedure is technically feasible. Long-term follow-up is mandatory to validate oncological outcome.
在残胃癌患者中，残胃全切除加淋巴结清扫是前提。
我们首次成功完成了五例残胃癌的全腹腔镜完全胃切除术（TLCG）。
五例残胃癌患者均成功完成了 TLCG，术中无不良事件发生。患者的中位年龄为 72 岁（56-84 岁），其中男性 3 例，女性 2 例。其中 3 例为 Billroth I 重建，2 例为 Billroth II 重建，4 例为胃癌部分胃切除术，1 例为胃十二指肠溃疡。中位手术时间为 360 分钟；出血量为 20 毫升。中位淋巴结检出数为 19 枚。术后无并发症发生，所有患者均在术后第 9 天出院。
尽管 TLCG 治疗残胃癌是一项技术难度大、挑战性大的手术，需要仔细松解粘连，并沿大血管进行解剖，以及进行腔内吻合，但该手术在技术上是可行的。需要进行长期随访以验证肿瘤学结果。
