Journal Article 幽門側胃管部分切除を施行した食道癌術後早期胃管癌の1例
Distal gastrectomy for early gastric tube cancer : a case report
ユウヘイソク イカン ブブン セツジョ オ シコウ シタ ショクドウガン ジュツゴ ソウキ イカンガン ノ 1レイ

重田, 匡利  ,  山本, 直宗  ,  深光, 岳  ,  尼崎, 陽太郎  ,  岡, 一斉  ,  須藤, 学拓  ,  南, 佳秀  ,  植木, 幸一

67 ( 1 )  , pp.37 - 41 , 2018-02-01 , 山口大学医学会
A 75-year-old man who had undergone an esophagectomy and posterior mediastinal gastric tube reconstruction for esophageal cancer 3 years previously was diagnosed with mucosal gastric cancer type 0-IIb proximal to the pyloric ring on follow-up endoscopy. Biopsy revealed a poorly differentiated adenocarcinoma. Submucosal dissection was not indicated by endoscopy. Surgical resection of the distal gastric tube and indocyanine green fluorescence-guided biopsies of the lymph nodes along the right gastric artery were performed. Intraoperative pathological examination of the lymph nodes revealed no metastases. The patient developed postoperative pneumonia, but his condition improved rapidly and he was discharged on postoperative day 29. Pathological evaluation confirmed a poorly differentiated adenocarcinoma limited to the mucosa. The patient remains free of gastric cancer 3 years after resection. In such patients, resection and reconstruction of the gastric tube by the posterior mediastinal route can be a complicated procedure. It was successful in this patient because the lesion was located near the pylorus and was detected at an early stage. A standard surgical procedure for gastric tube cancer has not been established, but distal gastric tube resection with lymph node biopsy may be preferred in patients with tumors detected at an early stage.

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