内容紹介
A Case of Gastric Cancer Underwent Two-Stage Gastrectomy after Chemotherapy-Induced Perforation
Summary
A 70's man presenting with a chief complaint of stomachache was found to have advanced gastric cancer with a deep ulcer and some lymph-node metastases. We decided performing a curative operation after 2 courses of S-1 plus cisplatin. On the first course day 13 of chemotherapy, he complained of severe epigastralgia, and we diagnosed as generalized peritonitis due to perforation of gastric cancer. We performed an urgent laparoscopic operation, which made perforation simple closure and omentopexy. Curative distal gastrectomy with D2 lymph node dissection was successfully performed on postoperative day 16.
要旨
症例は70歳台,男性。主訴は腹痛。精査にて胃前庭部小弯側に潰瘍を伴う40 mm大の進行胃癌(cT3N2M0,cStage ⅢA)と診断した。術前化学療法としてS-1(80 mg/m2)+CDDP(60 mg/m2)療法2コース後にD2リンパ節郭清を伴う胃切除術を予定した。1コース目day 13に急激な心窩部痛が出現し,胃癌穿孔および汎発性腹膜炎と診断し,腹腔鏡下縫合閉鎖ドレナージ術を施行した。術後16日目,開腹幽門側胃切除術,D2リンパ節郭清,BillrothⅠ法再建術を施行した。二期的な治療戦略で根治切除を施行し得た胃癌穿孔症例を経験したので報告する。
目次
Summary
A 70's man presenting with a chief complaint of stomachache was found to have advanced gastric cancer with a deep ulcer and some lymph-node metastases. We decided performing a curative operation after 2 courses of S-1 plus cisplatin. On the first course day 13 of chemotherapy, he complained of severe epigastralgia, and we diagnosed as generalized peritonitis due to perforation of gastric cancer. We performed an urgent laparoscopic operation, which made perforation simple closure and omentopexy. Curative distal gastrectomy with D2 lymph node dissection was successfully performed on postoperative day 16.
要旨
症例は70歳台,男性。主訴は腹痛。精査にて胃前庭部小弯側に潰瘍を伴う40 mm大の進行胃癌(cT3N2M0,cStage ⅢA)と診断した。術前化学療法としてS-1(80 mg/m2)+CDDP(60 mg/m2)療法2コース後にD2リンパ節郭清を伴う胃切除術を予定した。1コース目day 13に急激な心窩部痛が出現し,胃癌穿孔および汎発性腹膜炎と診断し,腹腔鏡下縫合閉鎖ドレナージ術を施行した。術後16日目,開腹幽門側胃切除術,D2リンパ節郭清,BillrothⅠ法再建術を施行した。二期的な治療戦略で根治切除を施行し得た胃癌穿孔症例を経験したので報告する。