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Importance of intraoperative frozen section examination during laparoscopic pylorus preserving gastrectomy : a case of lymph node metastasis along the right gastric artery Takashi KIYOKAWA 1 , Souya NUNOBE 1 , Naoki HIKI 1 , Michitaka HONDA 1 , Yuri TANAKA 1 , Toshiharu YAMAGUCHI 1 1Department of Gastroenterological Surgery, Gastroenterological Center, Cancer Institute Hospital, Japanese Foundation for Cancer Research Keyword: 5番リンパ節転移 , 幽門保存胃切除術 , 腹腔鏡下手術 pp.685-689
Published Date 2013/11/15
DOI https://doi.org/10.11477/mf.4426101014
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A 65-year-old man was referred to our hospital after being diagnosed with gastric cancer. Because the diagnosis was mucosal cancer, endoscopic submucosal dissection was performed in February, 2012. Pathological examination revealed poorly differentiated adenocarcinoma with submucosal invasion and lymphatic invasion. For an additional treatment, laparoscopic pylorus-preserving gastrectomy with D1+ lymph node dissection was planned in May, 2012. During the operation, a station 5 lymph node measuring 6mm in diameter was noted. Intraoperative pathological examination revealed metastasis in this lymph node. The operation was converted to laparoscopic distal gastrectomy with D2 lymph node dissection and Roux-en-Y reconstruction. Even though the rate of metastasis to station 5 lymph nodes from submucosal gastric cancer located at the middle of the stomach is low, special attention should be given during laparoscopic surgery because of the lack of palpation which is one of the greatest disadvantages of laparoscopic surgery.


Copyright © 2013, JAPAN SOCIETY FOR ENDOSCOPIC SURGERY All rights reserved.

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電子版ISSN 2186-6643 印刷版ISSN 1344-6703 日本内視鏡外科学会

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