胃GIST，十二指腸腺腫に対し腹腔鏡・内視鏡合同手術を同時に施行した1例

A case of simultaneous laparoscopic and endoscopic cooperative surgery for GIST of the stomach and duodenal adenoma

◆要旨：症例は75歳，男性．他疾患の経過観察目的のCTで胃粘膜下腫瘍を認めたため紹介となった．上部消化管内視鏡検査で胃角部前壁にdelleを伴わない粘膜下腫瘍を認め，生検でGISTであった．また十二指腸下行脚の十二指腸乳頭対側に20mm大の0-Ⅱa病変を認め，生検でtubular adenomaであった．同時切除の方針とし，腹腔鏡・内視鏡合同胃・十二指腸部分切除術を施行した．術後合併症は特になく，第7病日に退院となった．今回胃・十二指腸に同時に腹腔鏡・内視鏡合同手術（laparoscopic and endoscopic cooperative surgery：LECS）を施行した症例を経験したため報告する．

　A 75-year-old man was referred to our hospital because a gastric submucosal tumor was found on follow-up CT for another disease. Upper gastrointestinal endoscopy showed a submucosal tumor without delle on the anterior wall of the gastric antrum and biopsy revealed a GIST. Type 0-IIa tumor was found contralateral to the duodenal papilla of the descending part of the duodenum and biopsy revealed tubular adenoma. The patient underwent laparoscopic and endoscopic cooperative partial resection of the stomach and duodenum. There were no postoperative complications and the patient was discharged on the seventh day. We report a case of simultaneous laparoscopic and endoscopic cooperative surgery（LECS） of the stomach and duodenum.