Department of Gastroenterological Surgery, Toranomon Hospital, Tokyo, Japan.
Okinaka Memorial Institute for Medical Research, Tokyo, Japan.
Asian J Endosc Surg. 2022 Jan;15(1):176-179. doi: 10.1111/ases.12946. Epub 2021 Apr 27.
Gastric lymphangioma (GLA) is an extremely rare tumor without an established therapeutic strategy. Surgical resection is considered the mainstay of treatment, although there is a high risk of local recurrence if negative margins are not achieved. A 51-year-old man underwent routine abdominal ultrasonography, which incidentally detected a 20-mm tumor adjacent to the lesser curvature of the stomach. GLA was suspected based on its polycystic appearance. After a 16-month monitoring period, laparoscopic resection was performed because of tumor growth and involvement of the left gastric artery. Intraoperative indocyanine green (ICG) navigation system revealed lymphatic drainage from the tumor, which we used to help determine the optimal excision line and minimize the loss of gastric volume. Pathological examination confirmed complete resection with negative margins and supported a diagnosis of lymphangioma. We performed laparoscopic radical resection of GLA under guidance from intraoperative ICG fluorescence imaging, which allowed us to maximize residual gastric volume.
胃淋巴管瘤（GLA）是一种极其罕见的肿瘤，目前尚无既定的治疗策略。手术切除被认为是主要的治疗方法，尽管如果不能达到阴性切缘，局部复发的风险很高。一名 51 岁男性接受了常规腹部超声检查，偶然发现胃小弯附近有一个 20 毫米的肿瘤。根据其多囊样外观怀疑为 GLA。在 16 个月的监测期后，由于肿瘤生长并累及胃左动脉，进行了腹腔镜切除。术中吲哚菁绿（ICG）导航系统显示肿瘤的淋巴引流，我们利用该系统帮助确定最佳切除线，最大程度减少胃体积的损失。病理检查证实完全切除且切缘阴性，支持淋巴管瘤的诊断。我们在术中 ICG 荧光成像的指导下进行了 GLA 的腹腔镜根治性切除术，使我们能够最大限度地保留胃的体积。
