内容紹介
Summary
Case 1: A 66-year-old man underwent esophagogastroduodenoscopy(EGD), which showed a slightly elevated lesion at the greater curvature of the cardia. We diagnosed gastric adenocarcinoma(tub1, 2)as a result of the biopsy. Endoscopic submucosal dissection(ESD)was performed. The pathological examination revealed a gastric adenocarcinoma of the fundic type(GA-FG), with a tumor depth of SM2. Consequently, laparoscopic gastrectomy was additionally performed. Case 2: A 65-year-old woman underwent EGD, which revealed a slightly elevated lesion at the posterior wall of the upper body. We made a diagnosis of GA-FG as on the basis of biopsy resuit. ESD was performed. A pathological examination revealed that the tumor depth was SM2. Consequently, laparoscopic gastrectomy was additionally performed. GA-FG rarely demonstrates metastasis and recurrence. Most cases undergo ESD, few reports of surgical resection exist. We report our experience of laparoscopic gastrectomy for GA-FG.
要旨
症例1は66歳,男性。当院の健診にて上部消化管内視鏡検査を施行し噴門部大弯に7 mm大の隆起性病変を認め(生検: tub1,2),早期胃癌の診断でendoscopic submucosal dissection(ESD)を施行した。病理所見で胃底腺型胃癌(gastric adenocarcinoma of the fundic type: GA-FG)の診断に至り,深達度SM2にて追加切除(腹腔鏡下噴門側胃切除術)を行った。症例2は65歳,女性。Helicobacter pylori(HP)除菌後のフォローの上部消化管内視鏡検査にて体上部後壁に8 mm大の隆起性病変を認め生検の結果,GA-FGと診断した。ESDを施行し,深達度SM2にて追加切除(腹腔鏡下噴門側胃切除術)を行った。胃底腺胃癌は低悪性度で予後良好とされており,診断治療目的に内視鏡的治療が行われることが多く外科的切除の報告は少ない。今回,ESD後に腹腔鏡下手術を行ったGA-FGの2例を経験したので文献的考察を含めて報告する。
目次
Case 1: A 66-year-old man underwent esophagogastroduodenoscopy(EGD), which showed a slightly elevated lesion at the greater curvature of the cardia. We diagnosed gastric adenocarcinoma(tub1, 2)as a result of the biopsy. Endoscopic submucosal dissection(ESD)was performed. The pathological examination revealed a gastric adenocarcinoma of the fundic type(GA-FG), with a tumor depth of SM2. Consequently, laparoscopic gastrectomy was additionally performed. Case 2: A 65-year-old woman underwent EGD, which revealed a slightly elevated lesion at the posterior wall of the upper body. We made a diagnosis of GA-FG as on the basis of biopsy resuit. ESD was performed. A pathological examination revealed that the tumor depth was SM2. Consequently, laparoscopic gastrectomy was additionally performed. GA-FG rarely demonstrates metastasis and recurrence. Most cases undergo ESD, few reports of surgical resection exist. We report our experience of laparoscopic gastrectomy for GA-FG.
要旨
症例1は66歳,男性。当院の健診にて上部消化管内視鏡検査を施行し噴門部大弯に7 mm大の隆起性病変を認め(生検: tub1,2),早期胃癌の診断でendoscopic submucosal dissection(ESD)を施行した。病理所見で胃底腺型胃癌(gastric adenocarcinoma of the fundic type: GA-FG)の診断に至り,深達度SM2にて追加切除(腹腔鏡下噴門側胃切除術)を行った。症例2は65歳,女性。Helicobacter pylori(HP)除菌後のフォローの上部消化管内視鏡検査にて体上部後壁に8 mm大の隆起性病変を認め生検の結果,GA-FGと診断した。ESDを施行し,深達度SM2にて追加切除(腹腔鏡下噴門側胃切除術)を行った。胃底腺胃癌は低悪性度で予後良好とされており,診断治療目的に内視鏡的治療が行われることが多く外科的切除の報告は少ない。今回,ESD後に腹腔鏡下手術を行ったGA-FGの2例を経験したので文献的考察を含めて報告する。