A case of gastric adenocarcinoma of fundic gland type resected by combination of laparoscopic and endoscopic approaches to neoplasia with non-exposure technique (CLEAN-NET)

被引：25

作者：

Kato M. ^{[1
]}

Uraoka T. ^{[1
]}

Isobe Y. ^{[2
]}

Abe K. ^{[1
]}

Hirata T. ^{[1
]}

Takada Y. ^{[1
]}

Wada M. ^{[1
]}

Takatori Y. ^{[1
]}

Takabayashi K. ^{[1
]}

Fujiyama Y. ^{[1
]}

Sekiya K. ^{[2
]}

Kawaguchi Y. ^{[2
]}

Sukeda A. ^{[3
]}

Shiraishi J. ^{[3
]}

机构：

[1] Department of Gastroenterology, National Hospital Organization Tokyo Medical Center, 2-5-1 Higashigaoka, Meguro-ku, Tokyo

[2] Department of Surgery, National Hospital Organization Tokyo Medical Center, Tokyo

[3] Department of Pathology, National Hospital Organization Tokyo Medical Center, Tokyo

来源：

Clinical Journal of Gastroenterology | 2015年 / 8卷 / 6期

关键词：

CLEAN-NET; Full-thickness resection; Fundic gland type; Gastric cancer; LECS;

D O I：

10.1007/s12328-015-0619-2

中图分类号：

学科分类号：

摘要：

A male in his eighties attended our hospital for further evaluation of gastric cancer. A gastroscopy revealed a whitish flat elevated lesion (Paris, 0-IIa) of 15 mm in diameter on the greater curvature of the proximal fornix. The preoperative diagnosis was intra-mucosal differentiated gastric cancer, and a novel therapeutic approach, combination of laparoscopic and endoscopic approaches to neoplasia with non-exposure technique (CLEAN-NET) was applied and the lesion was resected in a single piece without any complications. Histopathological findings revealed atypical glandular epithelium proliferated in the mucosa and shallow layer (300 μm) of submucosa. These cells stained positive for pepsinogen-I and the final diagnosis was gastric cancer of fundic gland type (GAFT). There was no lymph–vascular involvement and free horizontal and vertical margins were confirmed. CLEAN-NET could be a therapeutic option for GAFT at low risk of lymph node metastasis because it prevents excess wall defect and exposure of cancer cells into the peritoneal cavity. © 2015, Japanese Society of Gastroenterology.

引用

页码：393 / 399

页数：6

共 12 条

[1]

Ueyama H., Yao T., Nakashima Y., Hirakawa K., Oshiro Y., Hirahashi M., Et al., Gastric adenocarcinoma of fundic gland type (chief cell predominant type): proposal for a new entity of gastric adenocarcinoma, Am J Surg Pathol, 34, 5, pp. 609-619, (2010)

[2]

Hiki N., Nunobe S., Matsuda T., Hirasawa T., Yamamoto Y., Yamaguchi T., Laparoscopic endoscopic cooperative surgery, Dig Endosc, 27, 2, pp. 197-204, (2015)

[3]

Ueyama H., Matsumoto K., Nagahara A., Hayashi T., Yao T., Watanabe S., Gastric adenocarcinoma of the fundic gland type (chief cell predominant type), Endoscopy, 46, 2, pp. 153-157, (2014)

[4]

Yao T., Ueyama H., Kushima R., Nakashima Y., Hirakawa K., Oshiro Y., Et al., New type of gastric carcinoma/adenocarcinoma of the fundic gland type: its clinicopathological features and tumor development, Stomach Intest, 45, 7, pp. 1192-1202, (2010)

[5]

Kato M., Nishida T., Yamamoto K., Hayashi S., Kitamura S., Yabuta T., Et al., Scheduled endoscopic surveillance controls secondary cancer after curative endoscopic resection for early gastric cancer: a multicentre retrospective cohort study by Osaka University ESD study group, Gut, 62, 10, pp. 1425-1432, (2013)

[6]

Isomoto H., Shikuwa S., Yamaguchi N., Fukuda E., Ikeda K., Nishiyama H., Et al., Endoscopic submucosal dissection for early gastric cancer: a large-scale feasibility study, Gut, 58, 3, pp. 331-336, (2009)

[7]

Imagawa A., Okada H., Kawahara Y., Takenaka R., Kato J., Kawamoto H., Et al., Endoscopic submucosal dissection for early gastric cancer: results and degrees of technical difficulty as well as success, Endoscopy, 38, 10, pp. 987-990, (2006)

[8]

Hiki N., Yamamoto Y., Fukunaga T., Yamaguchi T., Nunobe S., Tokunaga M., Et al., Laparoscopic and endoscopic cooperative surgery for gastrointestinal stromal tumor dissection, Surg Endosc, 22, 7, pp. 1729-1735, (2008)

[9]

Nunobe S., Hiki N., Gotoda T., Murao T., Haruma K., Matsumoto H., Et al., Successful application of laparoscopic and endoscopic cooperative surgery (LECS) for a lateral-spreading mucosal gastric cancer, Gastric Cancer, 15, 3, pp. 338-342, (2012)

[10]

Inoue H., Ikeda H., Hosoya T., Yoshida A., Onimaru M., Suzuki M., Et al., Endoscopic mucosal resection, endoscopic submucosal dissection, and beyond: full-layer resection for gastric cancer with nonexposure technique (CLEAN-NET), Surg Oncol Clin N Am, 21, 1, pp. 129-140, (2012)

← 1 2 →