Nakano Hiroshi, Furukawa Hiroshi, Nakamuro Makoto, Kondo Yoshiaki, Ishikawa Kazuo, Okubo Yuhei, Oota Yoshio
Dept. of Surgery, Seikeikai Hospital.
Gan To Kagaku Ryoho. 2017 Nov;44(12):1680-1682.
A 83-year-old man was diagnosed an earlygastric remnant cancer on the site of jejuno-gastrostomyafter proximal gastrectomywith jejunum interposing reconstruction 23 years ago. A total gastrectomywas performed due to the difficultyof endoscopic submucosal resection. The surgical operation took 200 minutes and the blood loss was 180 mL. Histologically, tumor size was 28×22mm invading to submucosal layer with a lymph node metastasis. To reduce the risk of surgical operation for gastric remnant cancer of aged patients, a simple reconstruction method is important for proximal gastrectomy, like a esophagogastrostomyplacing a gastric tube in the mediastinum.
一名83岁男性在23年前接受近端胃切除空肠间置重建术后，在空肠造口部位被诊断为早期残胃癌。由于内镜下黏膜下切除术困难，遂行全胃切除术。手术历时200分钟，失血量为180毫升。组织学检查显示，肿瘤大小为28×22毫米，侵犯至黏膜下层并伴有淋巴结转移。为降低老年患者残胃癌手术风险，对于近端胃切除术而言，一种简单的重建方法很重要，比如在纵隔内放置胃管的食管胃吻合术。
