[远端胃切除术后残胃胃肠道间质瘤行倒L型腹腔镜扩大胃切除术1例]

[A Case of Inverted LECS for GIST in the Remnant Stomach after Distal Gastrectomy].

作者信息

Watanabe Megumi, Nishizaki Masahiko, Takenaka Ryuta, Takei Kensuke, Mikane Yu, Shoji Ryohei, Okada Tsuyoshi, Aoyama Katsuyuki, Nogami Tomohiro, Nishikawa Hitoshi, Shinoura Susumu, Shigemitsu Kaori, Nonaka Yasuyuki, Hayashi Dofu

机构信息

Dept. of Surgery, Tsuyama Chuo Hospital.

出版信息

Gan To Kagaku Ryoho. 2019 Dec;46(13):1954-1956.

PMID:32157024

Abstract

Laparoscopy and endoscopy cooperative surgery(LECS)is the surgical procedure used to avoid excessive resection of the gastrointestinal wall and preserve its function. We report the case of a patient who was successfully treated with inverted LECS for gastrointestinal stromal tumor(GIST)in the remnant stomach and underwent distal gastrectomy. The patient was a 75- year-old man who received distal gastrectomy for gastric ulcer 28 years before. Three years before he was diagnosed as having gastric submucosal tumor(SMT)as a gastrointestinal tumor(GIST)by using EUS. As the tumor increased, he was admitted to our hospital. Upper gastrointestinal endoscopy revealed a 30mm SMT just below the cardiac part of the remnant stomach. Biopsy by EUS-FNA revealed CD34(-), c-kit(+), S-100(-), and a-SMA(-), which indicated gastric GIST. Inverted LECS was performed. His postoperative course was good, and he was discharged from the hospital 9 days after the surgery.

摘要

腹腔镜与内镜联合手术（LECS）是一种用于避免过度切除胃肠道壁并保留其功能的外科手术。我们报告了一例患者，该患者因残胃胃肠道间质瘤（GIST）接受了倒转式LECS治疗，并接受了远端胃切除术，治疗成功。该患者为一名75岁男性，28年前因胃溃疡接受了远端胃切除术。三年前，他经超声内镜（EUS）诊断为胃黏膜下肿瘤（SMT），为胃肠道肿瘤（GIST）。随着肿瘤增大，他入住我院。上消化道内镜检查显示，残胃贲门部下方有一个30mm的SMT。超声内镜引导下细针穿刺活检（EUS-FNA）显示CD34（-）、c-kit（+）、S-100（-）和α-平滑肌肌动蛋白（-），提示胃GIST。遂行倒转式LECS。术后恢复良好，术后9天出院。