Ushimaru Yuki, Fujiwara Yoshiyuki, Shishido Yuji, Omori Takeshi, Yanagimoto Yoshitomo, Sugimura Keijirou, Moon Jeong-Ho, Miyata Hiroshi, Yano Masahiko
Department of Surgery, Osaka International Cancer Institute, Osaka, Japan.
Asian J Endosc Surg. 2019 Oct;12(4):457-460. doi: 10.1111/ases.12678. Epub 2018 Dec 27.
Preoperative staging laparoscopy is used to search for peritoneal dissemination or distant metastasis as part of the treatment strategy for advanced gastric cancer. We observed pseudo-peritoneal metastasis during laparotomy in 6 of 49 patients in whom lack of peritoneal dissemination had been confirmed by preoperative staging laparoscopy. In all cases, suspected nodules were biopsied and subjected to rapid histological diagnosis. However, a definite malignant or benign diagnosis could not be obtained via a rapid histological examination during surgery. A final histological examination combined with immunohistological analysis using formalin-fixed embedded tissues confirmed no malignancy after surgery in all cases. These rapidly growing nodules that mimic peritoneal metastasis are thought to be associated with the use of grasping forceps during staging laparoscopy. No cases have been reported in which peritoneal nodules mimicking peritoneal metastasis occurred after staging laparoscopy, and surgeons should consider this possibility in patients treated shortly after staging laparoscopy.
术前分期腹腔镜检查作为晚期胃癌治疗策略的一部分，用于查找腹膜播散或远处转移。在49例经术前分期腹腔镜检查确认无腹膜播散的患者中，我们在剖腹手术期间观察到6例存在假腹膜转移。所有病例中，对疑似结节进行了活检并进行快速组织学诊断。然而，在手术期间通过快速组织学检查无法获得明确的恶性或良性诊断。最终的组织学检查结合使用福尔马林固定包埋组织的免疫组织学分析证实，所有病例术后均无恶性病变。这些类似腹膜转移的快速生长结节被认为与分期腹腔镜检查期间使用抓钳有关。尚未有关于分期腹腔镜检查后出现类似腹膜转移的腹膜结节的病例报道，外科医生应在分期腹腔镜检查后不久接受治疗的患者中考虑这种可能性。
