Sato Shota, Kawazoe Tetsuro, Tanaka Yasushi, Ota Mitsuhiko, Oki Eiji, Yoshizumi Tomoharu
Department of Surgery and Science, Kyushu University, Fukuoka, Japan.
Department of Surgery and Science, Kyushu University, Fukuoka, Japan.
Int J Surg Case Rep. 2024 Dec;125:110617. doi: 10.1016/j.ijscr.2024.110617. Epub 2024 Nov 19.
Brunner's gland hamartoma is a rare benign duodenal tumor. Resection is recommended for large or symptomatic lesions, but conventional pancreaticoduodenectomy and other procedures can be overly invasive for the lesion. We report a case of Brunner's gland hamartoma resected using laparoscopic and endoscopic cooperative surgery (LECS).
A 51-year-old woman was referred to our hospital with an asymptomatic duodenal tumor that had increased in size. A submucosal tumor was found on the anterior wall of the duodenal bulb during a detailed examination, and surgery was performed because the tumor was large (2 cm). In order to optimally resect the tumor, duodenal LECS (D-LECS) was selected. The resection line was determined while checking the base of the lesion with an intraoperative endoscope, and after the lesion was resected, the mucosal defect was closed using laparoscopic manipulation. Histopathological evaluation revealed Brunner's gland hyperplasia and mixed smooth muscle bundles, and the lesion was diagnosed as a Brunner's gland hamartoma. The surgery was completed without any problems, and the patient made a full recovery after the surgery with no complications such as stenosis, and no recurrence was observed.
With D-LECS, the lesion can be resected without excess or deficiency, and the incision can be sutured with minimal invasiveness. D-LECS is an effective method as a treatment option for Brunner's gland hamartoma.
We herein report a case of Brunner's gland hamartoma treated safely with a minimally invasive surgical technique: D-LECS.
布伦纳腺错构瘤是一种罕见的十二指肠良性肿瘤。对于较大或有症状的病变，建议进行切除，但传统的胰十二指肠切除术和其他手术对于该病变可能具有过度的侵袭性。我们报告一例采用腹腔镜与内镜联合手术（LECS）切除布伦纳腺错构瘤的病例。
一名51岁女性因无症状十二指肠肿瘤增大而转诊至我院。详细检查时在十二指肠球部前壁发现一个黏膜下肿瘤；由于肿瘤较大（2厘米），遂进行手术。为了最佳地切除肿瘤，选择了十二指肠LECS（D-LECS）。术中通过内镜检查病变基部的同时确定切除线，切除病变后，利用腹腔镜操作关闭黏膜缺损。组织病理学评估显示布伦纳腺增生和混合平滑肌束，该病变被诊断为布伦纳腺错构瘤。手术顺利完成，患者术后完全康复，无狭窄等并发症，且未观察到复发。
采用D-LECS，可无过多或不足地切除病变，且能以最小的侵袭性缝合切口。D-LECS作为布伦纳腺错构瘤的一种治疗选择是一种有效的方法。
我们在此报告一例采用微创外科技术D-LECS安全治疗布伦纳腺错构瘤的病例。
