{"title":"Two-stage robotic gastrectomy after bypass surgery for a perforated non-curative endoscopic submucosal dissection scar: a case report.","authors":"Makoto Hikage, Taeko Matsuura, Keiichiro Kawamura, Masato Yamada, Takuya Jimbo, Munetaka Hashimoto, Shunsuke Shibuya, Yasushi Ito, Kazuyuki Kusuda, Yuji Goukon","doi":"10.1007/s13691-025-00766-x","DOIUrl":null,"url":null,"abstract":"<p><p>Here, we report a case of scar perforation caused by endoscopic dilation while the patient was waiting for additional gastrectomy after non-curative endoscopic submucosal dissection (ESD) for early gastric cancer. Although conservative treatment prevented the progression of generalized peritonitis, one-stage meticulous surgery was contraindicated because of abscess formation around the pylorus, which is the main target of lymphatic dissection. Therefore, we performed a two-stage surgery. Prior laparoscopic gastrojejunal bypass for peritonitis control and nutritional management allowed for uncompromised curative gastrectomy using a robotic approach. Among the various treatment strategies, our selected two-stage surgery was useful in achieving uncompromised cancer surgery in patients with perforated peritonitis after noncurative ESD, where prophylactic dissection was the primary objective.</p><p><strong>Supplementary information: </strong>The online version contains supplementary material available at 10.1007/s13691-025-00766-x.</p>","PeriodicalId":13703,"journal":{"name":"International Cancer Conference Journal","volume":"14 3","pages":"274-279"},"PeriodicalIF":0.5000,"publicationDate":"2025-04-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12229416/pdf/","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"International Cancer Conference Journal","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.1007/s13691-025-00766-x","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2025/7/1 0:00:00","PubModel":"eCollection","JCR":"Q4","JCRName":"ONCOLOGY","Score":null,"Total":0}
引用次数: 0
Abstract
Here, we report a case of scar perforation caused by endoscopic dilation while the patient was waiting for additional gastrectomy after non-curative endoscopic submucosal dissection (ESD) for early gastric cancer. Although conservative treatment prevented the progression of generalized peritonitis, one-stage meticulous surgery was contraindicated because of abscess formation around the pylorus, which is the main target of lymphatic dissection. Therefore, we performed a two-stage surgery. Prior laparoscopic gastrojejunal bypass for peritonitis control and nutritional management allowed for uncompromised curative gastrectomy using a robotic approach. Among the various treatment strategies, our selected two-stage surgery was useful in achieving uncompromised cancer surgery in patients with perforated peritonitis after noncurative ESD, where prophylactic dissection was the primary objective.
Supplementary information: The online version contains supplementary material available at 10.1007/s13691-025-00766-x.
期刊介绍:
This online-only journal publishes original case reports on all types of cancer. In particular, we welcome not only case reports of educational value in the diagnosis and treatment of cancers, but also reports on molecularly analyzed cancer cases, including gene mutations, gene fusions, gene expression, and changes in copy number, regardless of their known clinical significance. Assessing the molecular analysis of a tumor usually requires a “cancer conference” in which experts from various fields discuss it. Even if the authors and their respective “cancer conference” were unable to determine the clinical significance of molecular changes at the time of submission and publication, their data may provide evidence that will help the scientific community develop precision medicine solutions in the future. We welcome case reports with reviews of the literature on similar cases, as they are more useful and valuable to readers than are reports of rare cases. International Cancer Conference Journal is the official publication of the Japan Society of Clinical Oncology (JSCO).
- Presents an online-only collection of original case reports on all types of cancer
- In particular, welcomes molecularly analyzed cancer cases
- The Official Publication of the Japan Society of Clinical Oncology (JSCO)