用半圆形蚕膜层切口成功切除贲门附近的胃腺体囊肿:病例报告和视频演示。

IF 2.5 3区 医学 Q3 ONCOLOGY
Hitoshi Hara, Seito Shimizu, Yasuhide Muto, Tomoki Kido, Ryohei Miyata, Moe Tokuda, Kyuichiro Takahashi, Tomohiro Maesono, Takahiro Ajihara, Aki Yagi, Takuma Naritomi, Michio Itabashi
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引用次数: 0

摘要

背景:结合腹腔镜和内镜方法治疗肿瘤的无暴露技术(CLEAN-NET)是一种腹腔镜和内镜合作手术(LECS)。它结合了腹腔镜胃切除术和内镜技术,用于胃肿瘤(如胃肠道间质瘤(GIST))的局部切除,手术切缘最小。传统的 CLEAN-NET 手术过程非常复杂,需要小心翼翼地保留贲门,尤其是在附近有病灶的情况下。我们描述了一例采用改良CLEAN-NET方法的患者的病例,该方法采用围绕肿瘤底部的半圆形血清肌层切口,不同于传统CLEAN-NET的圆形血清肌层切口:肿瘤周围保留粘膜连续性,作为避免术中肿瘤扩散的屏障:一名 43 岁的女性因体检发现贲门附近有胃黏膜下肿瘤而转诊至我院。根据内镜超声引导下细针穿刺的结果,患者被诊断为胃 GIST。改良的CLEAN-NET手术在贲门对侧的浆肌层做半圆形切口,使手术过程简单,并在保留贲门的同时,最大限度地减少了对胃壁(包括肿瘤)的部分切除。手术时间为147分钟,术前失血量为3毫升,术后住院9天。切除的标本显示,包括肿瘤在内的胃壁得到了最小程度的切除。保留了贲门和胃神经,术后进食情况良好:结论:改良的CLEAN-NET半圆形浆肌层剥离术是治疗贲门附近GIST的一种简单可靠的手术方法。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Successful modified CLEAN-NET with semicircular seromuscular layer incision for a gastric GIST near the cardia: a case report and video demonstration.

Background: The combination of laparoscopic and endoscopic approaches to neoplasia with a non-exposure technique (CLEAN-NET) is a laparoscopic and endoscopic cooperative surgery (LECS). It combines laparoscopic gastric resection and endoscopic techniques for local resection of gastric tumors, such as gastrointestinal stromal tumors (GIST), with minimal surgical margins. A conventional CLEAN-NET surgical procedure is complex, requiring careful techniques to preserve the cardia, particularly in case of nearby lesions. We describe the case of a patient who underwent a modified CLEAN-NET approach with a semi-circular seromuscular layer incision surrounding the base of the tumor, different from a circular shape seromuscular layer in the conventional CLEAN-NET: around the tumor to preserve mucosal continuity, which acts as a barrier to avoid intraoperative tumor dissemination.

Case presentation: A 43-year-old woman was referred to our hospital because of a gastric submucosal tumor near the cardia, detected on medical examination. The patient was diagnosed with gastric GIST based on the results of endoscopic ultrasound-guided fine-needle aspiration. Modified CLEAN-NET was performed with a semicircular incision of the seromuscular layer on the opposite side of the cardia, making the surgical procedure simple and minimizing partial resection of the gastric wall, including the tumor, while preserving the cardia. The operative time was 147 min, preoperative blood loss volume was 3 mL, and postoperative hospital stay was 9 days. The resected specimen revealed a minimal resection of the gastric wall, including the tumor. The cardia and gastric nerves were preserved, and the postoperative food intake was good.

Conclusions: The modified CLEAN-NET with semicircular seromuscular layer dissection is a simple and reliable surgical procedure for GIST near the cardia.

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来源期刊
CiteScore
4.70
自引率
15.60%
发文量
362
审稿时长
3 months
期刊介绍: World Journal of Surgical Oncology publishes articles related to surgical oncology and its allied subjects, such as epidemiology, cancer research, biomarkers, prevention, pathology, radiology, cancer treatment, clinical trials, multimodality treatment and molecular biology. Emphasis is placed on original research articles. The journal also publishes significant clinical case reports, as well as balanced and timely reviews on selected topics. Oncology is a multidisciplinary super-speciality of which surgical oncology forms an integral component, especially with solid tumors. Surgical oncologists around the world are involved in research extending from detecting the mechanisms underlying the causation of cancer, to its treatment and prevention. The role of a surgical oncologist extends across the whole continuum of care. With continued developments in diagnosis and treatment, the role of a surgical oncologist is ever-changing. Hence, World Journal of Surgical Oncology aims to keep readers abreast with latest developments that will ultimately influence the work of surgical oncologists.
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