Totally Laparoscopic Total Gastrectomy with Oesophagus-Duodenal Interposition of a Pedicled Jejunal Flap in a Patient with Familial Adenomatous Polyposis (with video)

Q4 Medicine
J. Barbosa, F. Sousa, Manuela Batista, Jose Pedro Barbosa, E. Barbosa
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引用次数: 0

Abstract

Introduction: Several interposition techniques have been described for reconstruction after total gastrectomy in FAP patients, in open (1) and laparoscopic assisted surgery (2,3,4). The Longmire technique has the advantage of allowing all the food to pass through the duodenum and better absorption of nutrients, such as iron (5). Here, we describe the use of a pedicled isoperistaltic jejunal flap interposition technique to reconstruct the digestive tract after total gastrectomy, fully performed by laparoscopic approach, in a patient with FAP that had previous total colectomy. Our patient was a 68-year-old woman, with “MUTYH-Associated Polyposis (MAP)”, a c.494A>G mutation at exon 7 and c.1145G>A mutation at exon 13. She was diagnosed with gastric cancer and lesions of high- and low-grade dysplasia. She was previously submitted to a laparoscopic total colectomy, 2009, and a conservative breast surgery plus chemoradiotherapy in 2017. She also had duodenal and rectum polyps in her surveillance months, without any relevant symptoms. Conclusion: We hereby describe a technique that has been previously used by others with good results, but with the novel contribution of performing the surgery entirely by laparoscopy.
全腹腔镜下食管-十二指肠间置带蒂空肠瓣全胃切除术治疗家族性腺瘤性息肉病1例(附视频)
介绍:已有几种介入技术用于FAP患者全胃切除术后的重建,包括开放手术(1)和腹腔镜辅助手术(2,3,4)。Longmire技术的优点是允许所有食物通过十二指肠,更好地吸收营养物质,如铁(5)。在这里,我们描述了使用带蒂等蠕动空肠瓣介入技术来重建全胃切除术后的消化道,全胃切除术完全由腹腔镜手术进行,患者患有FAP,之前进行了全结肠切除术。我们的患者是一名68岁的女性,患有“MUTYH-Associated Polyposis (MAP)”,在第7外显子有c.494A>G突变,在第13外显子有c.1145G> a突变。她被诊断为胃癌和高、低级别不典型增生病变。2009年,她接受了腹腔镜全结肠切除术,2017年接受了保守乳房手术加放化疗。在她的监测月,她也有十二指肠和直肠息肉,没有任何相关症状。结论:我们在此描述一种以前被其他人使用并取得良好效果的技术,但具有完全通过腹腔镜进行手术的新贡献。
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来源期刊
Surgery, Gastroenterology and Oncology
Surgery, Gastroenterology and Oncology Medicine-Gastroenterology
CiteScore
0.30
自引率
0.00%
发文量
11
期刊介绍: Starting with this issue "Annals of Fundeni Hospital", founded in 1996 as the scientific journal of the prestigious hospital Fundeni becomes "Journal of Translational Medicine and Research" (JTMR), an Journal of the Academy of Medical Sciences of Romania. Therefore, an 18 years old Journal, attested and indexed in Elsevier Bibliographic Databases, Amsterdam and also indexed in SCOPUS, is continuing a tradition of excellence that lasted almost two decades. The new title of the Journal is inspired first of all from the important developments of translational research In Fundeni Clinical Institute and the "C.C Iliescu Institute for Cardio-Vascular Diseases", in parallel with the national and international trend to promote and develop this important area or medical research. Although devoted mainly to translational research, JTMR will continue to promote both basic and clinical research.
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