家族性腺瘤性息肉病全胃切除术后十二指肠息肉病的内镜监测
Endoscopic Surveillance of Duodenal Polyposis After Total Gastrectomy in Familial Adenomatous Polyposis.
作者信息
Shah Ravi S, Mehta Neal, Mankaney Gautam, Walsh Matthew R, Burke Carol A, Bhatt Amit
机构信息
Department of Internal Medicine, Medicine Institute, Cleveland Clinic, Cleveland, OH.
Department of Gastroenterology, Hepatology and Nutrition, Digestive Disease and Surgery Institute, Cleveland Clinic, Cleveland, OH.
出版信息
ACG Case Rep J. 2020 Aug 20;7(8):e00445. doi: 10.14309/crj.0000000000000445. eCollection 2020 Aug.
The lifetime incidence of duodenal polyposis in familial adenomatous polyposis (FAP) approaches 100%, and duodenal cancer is the most common malignancy once colectomy is performed. The incidence of gastric cancer is increasing in patients with FAP, and when gastric polyps with high-grade dysplasia or cancer are present, a total gastrectomy with Roux-en-Y esophagojejunostomy is indicated. The altered anatomy after surgery and presence of adhesions from a previous colectomy make endoscopic surveillance of the duodenum with standard equipment difficult. This case report highlights an approach to duodenal polyposis surveillance in FAP after total gastrectomy with Roux-en-Y esophagojejunostomy.
家族性腺瘤性息肉病（FAP）患者十二指肠息肉病的终生发病率接近100%，一旦进行结肠切除术，十二指肠癌是最常见的恶性肿瘤。FAP患者中胃癌的发病率正在上升，当存在高级别异型增生或癌症的胃息肉时，建议行全胃切除术加Roux-en-Y食管空肠吻合术。手术后解剖结构改变以及既往结肠切除术导致的粘连使得使用标准设备对十二指肠进行内镜监测变得困难。本病例报告强调了在全胃切除术加Roux-en-Y食管空肠吻合术后对FAP患者十二指肠息肉病进行监测的一种方法。
Zotero 插件