Yoshitake Kenichiro, Kumashiro Yuji, Watanabe Takaaki, Adachi Mio, Matsui Satoshi, Kurimori Kou, Ikeda Naoya, Nakamura Hiroshi, Omoto Yawara, Fujita Yuki, Nishikage Tetsuro, Kato Shuji, Kanenobu Masaaki, Tsubaki Masahiro, Kato Shoichi
Dept. of Surgery and Gastroenterology, Yuai Memorial Hospital.
Gan To Kagaku Ryoho. 2016 Nov;43(12):1875-1877.
A 69-year-old man underwent esophagogastroduodenoscopy, which showed a slightly depressed lesion at the greater curvature of the gastric body. We diagnosed gastric adenocarcinoma of the fundic gland type(GA-FG)from examination of the biopsy specimen. Endoscopic submucosal dissection(ESD)was performed for curative resection. The pathological examination revealed a positive vertical margin. Consequently, laparoscopic gastrectomy was additionally performed. GA-FG has recently been proposed as a new entity of gastric adenocarcinoma. GA-FG mostly develops without Helicobacter pylori infection and often invades the submucosa, regardless of size. However, GA-FG rarely demonstrates lymphatic and venous invasion despite deep submucosal invasion. Since most GA-FG cases undergo ESD, few reports of surgical resection exist. Here, we report our experience of laparoscopic gastrectomy for GA-FG.
一名69岁男性接受了食管胃十二指肠镜检查，结果显示胃体大弯处有一个轻度凹陷性病变。通过对活检标本的检查，我们诊断为胃底腺型胃癌（GA-FG）。为了进行根治性切除，实施了内镜下黏膜下剥离术（ESD）。病理检查显示切缘垂直方向阳性。因此，又额外进行了腹腔镜胃切除术。GA-FG最近被提出作为胃癌的一种新类型。GA-FG大多在无幽门螺杆菌感染的情况下发生，且无论大小，常侵犯黏膜下层。然而，尽管GA-FG侵犯黏膜下层较深，但很少出现淋巴和静脉侵犯。由于大多数GA-FG病例接受ESD治疗，因此关于手术切除的报道很少。在此，我们报告我们对GA-FG进行腹腔镜胃切除术的经验。
