内容紹介
Summary
A 90-year-old female patient was admitted to our hospital with a chief complaint of vomiting. Gastroscopy revealed type 3 gastric cancer and gastric outlet obstruction(GOO). Abdominal computed tomography revealed thickening of the antral wall and suggested the presence of 3 perigastric lymph node metastases, but there was no ascitic fluid or distant metastasis. The clinical diagnosis was T4a(SE)N2H0CYXP0M0, Stage ⅢB, according to the Japanese Classification of Gastric Carcinoma. Her general conditions including kidney and cardiac function were good, we considered that she was able to tolerate radical distal gastrectomy. We planned laparoscopic distal gastrectomy(LDG)and D2 lymphadenectomy after getting sufficient informed consent. The patient experienced an uneventful post-operative recovery, and was discharged in good health 11 days after surgery.
要旨
症例は90歳,女性。食思不振,嘔吐を主訴に当科を受診した。上部消化管内視鏡検査にて,胃前庭部に亜全周性の進行胃癌を認めた。腹部造影CT検査で幽門上下に計3個のリンパ節腫大を認めたが,腹水や遠隔転移はなくcT4a(SE)N2H0CYXP0M0,cStage ⅢBと診断した。耐術能は問題なく,十分なインフォームド・コンセントを行った上で,腹腔鏡下幽門側胃切除術,D2リンパ節郭清,Roux-en-Y法再建を施行した。せん妄や肺合併症を含め術後合併症はなく,術後第11病日に退院となった。
目次
A 90-year-old female patient was admitted to our hospital with a chief complaint of vomiting. Gastroscopy revealed type 3 gastric cancer and gastric outlet obstruction(GOO). Abdominal computed tomography revealed thickening of the antral wall and suggested the presence of 3 perigastric lymph node metastases, but there was no ascitic fluid or distant metastasis. The clinical diagnosis was T4a(SE)N2H0CYXP0M0, Stage ⅢB, according to the Japanese Classification of Gastric Carcinoma. Her general conditions including kidney and cardiac function were good, we considered that she was able to tolerate radical distal gastrectomy. We planned laparoscopic distal gastrectomy(LDG)and D2 lymphadenectomy after getting sufficient informed consent. The patient experienced an uneventful post-operative recovery, and was discharged in good health 11 days after surgery.
要旨
症例は90歳,女性。食思不振,嘔吐を主訴に当科を受診した。上部消化管内視鏡検査にて,胃前庭部に亜全周性の進行胃癌を認めた。腹部造影CT検査で幽門上下に計3個のリンパ節腫大を認めたが,腹水や遠隔転移はなくcT4a(SE)N2H0CYXP0M0,cStage ⅢBと診断した。耐術能は問題なく,十分なインフォームド・コンセントを行った上で,腹腔鏡下幽門側胃切除術,D2リンパ節郭清,Roux-en-Y法再建を施行した。せん妄や肺合併症を含め術後合併症はなく,術後第11病日に退院となった。