Hosoda Kei, Yamashita Keishi, Moriya Hiromitsu, Washio Marie, Mieno Hiroaki, Ema Akira, Watanabe Masahiko
Department of Surgery, Kitasato University School of Medicine, Sagamihara, Japan.
Asian J Endosc Surg. 2018 May;11(2):160-164. doi: 10.1111/ases.12419. Epub 2017 Aug 30.
A 66-year-old man was referred to our hospital for treatment of esophagogastric junction cancer. He was diagnosed as cT2N0M0, and the esophageal invasion was found to be 1 cm from the esophagogastric junction. He underwent laparoscopy-assisted proximal gastrectomy and lower esophagectomy with esophagogastrostomy using the intrathoracic double-flap technique through the transhiatal approach. The operative time was 662 min (suturing time was 198 min), and blood loss was 200 mL. The operative time was much longer for this procedure than for esophagogastrostomy with the conventional (intra-abdominal) double-flap technique. The postoperative course was uneventful. No abnormal gastroesophageal reflux, esophageal motility, or lower esophageal sphincter (LES) pressure was demonstrated 3 months after the operation. Laparoscopic proximal gastrectomy and lower esophagectomy with esophagogastrostomy using the double-flap technique through the transhiatal approach is safe and feasible. It may be recommended for patients with esophagogastric junction cancer with esophageal invasion of about 1 cm.
一名66岁男性因食管胃交界部癌被转诊至我院接受治疗。他被诊断为cT2N0M0，发现食管侵犯距食管胃交界部1厘米。他接受了腹腔镜辅助近端胃切除术和经裂孔入路的胸内双瓣技术食管胃吻合的低位食管切除术。手术时间为662分钟（缝合时间为198分钟），失血200毫升。该手术的手术时间比传统（腹内）双瓣技术的食管胃吻合术长得多。术后过程顺利。术后3个月未发现异常的胃食管反流、食管动力或食管下括约肌（LES）压力。经裂孔入路使用双瓣技术进行腹腔镜近端胃切除术和低位食管切除术并食管胃吻合是安全可行的。对于食管侵犯约1厘米的食管胃交界部癌患者，可能推荐采用该术式。
