Department of Surgery, Hiroshima City Hiroshima Citizens Hospital, Hiroshima, Japan.
Asian J Endosc Surg. 2021 Oct;14(4):782-785. doi: 10.1111/ases.12919. Epub 2021 Feb 5.
We present a case of early gastric cancer in the pylorus with a type 3 hiatal hernia, which was treated by endoscopic submucosal dissection (ESD). A 70-year-old man was referred to our hospital with a hiatal hernia. Endoscopy revealed early gastric cancer, and we performed an ESD adaptation at the pylorus. The ESD was successful, but post-ESD pyloric stenosis occurred. Symptoms of hiatal hernia worsened because of the pyloric stenosis. Laparoscopic hiatal hernia repair with Toupet fundoplication and Heineke-Mikulicz pyloroplasty was simultaneously performed. The postoperative course was good, and follow-up after discharge was uneventful. To our knowledge, there have been no reports in which laparoscopic hiatal hernia repair, fundoplication, and pyloroplasty were simultaneously performed for a substantial hiatal hernia with post-ESD pyloric stenosis.
我们报告了一例贲门部 3 型食管裂孔疝合并早期胃癌，采用内镜黏膜下剥离术（ESD）治疗。一名 70 岁男性因食管裂孔疝就诊于我院。内镜检查发现早期胃癌，我们在贲门处进行了 ESD 适应治疗。ESD 成功，但术后发生幽门狭窄。由于幽门狭窄，食管裂孔疝的症状恶化。我们同时行腹腔镜食管裂孔疝修补术（Toupet 胃底折叠术）和 Heineke-Mikulicz 幽门成形术。术后恢复良好，出院后随访无异常。据我们所知，对于 ESD 术后发生幽门狭窄的巨大食管裂孔疝，同时行腹腔镜食管裂孔疝修补术、胃底折叠术和幽门成形术的病例尚未见报道。
