Yoshiyama Shigeyuki, Imaoka Hiroki, Yasuda Hiromi, Ohi Masaki, Katsurahara Masaki, Hamada Yasuhiko, Miura Hirotsugu, Nakamura Misaki, Kojima Shinichi, Mohri Yasuhiko, Kusunoki Masato
Dept. of Gastrointestinal and Pediatric Surgery, Mie University.
Gan To Kagaku Ryoho. 2017 Nov;44(12):1553-1555.
We report a case ofsuperf icial non-ampullary duodenal tumor(SNADT)resected by laparoscopic and endoscopic cooperative surgery(LECS)technique.
A 55-year-old man underwent screening esophagogastroduodenoscopy. Endoscopy revealed 0- II a+ II c mucosal lesion measuring 15mm in size located the portion ofduodenum contralateral to the ampulla ofVater. During observation, irregularity in depressed mucosa was observed and malignant alteration was suspected. So, we performed local resection with LECS as diagnostic therapy. During operation, endoscopic mucosal resection(ESD)was performed first. Next, duodenum was mobilized laparoscopically and the floor of the ulcer was closed with endoscopy guided laparoscopic suturing technique. Histopathology revealed tubular adenoma and the resection margin was negative.
SNADT is rare condition and therapeutic strategy for SNADT has not established. Further study are needed.
我们报告一例通过腹腔镜与内镜联合手术（LECS）技术切除的浅表非壶腹十二指肠肿瘤（SNADT）病例。
一名55岁男性接受了食管胃十二指肠镜筛查。内镜检查发现一个大小为15mm的0-IIa + IIc型黏膜病变，位于十二指肠与 Vater 壶腹相对的部位。在观察过程中，发现凹陷黏膜不规则，怀疑有恶性改变。因此，我们采用LECS进行局部切除作为诊断性治疗。手术过程中，首先进行了内镜黏膜下剥离术（ESD）。接下来，通过腹腔镜游离十二指肠，并在内镜引导下采用腹腔镜缝合技术关闭溃疡底部。组织病理学显示为管状腺瘤，切缘阴性。
SNADT是一种罕见疾病，SNADT的治疗策略尚未确立。需要进一步研究。
