早期十二指腸癌に対して腹腔鏡補助下内視鏡的粘膜剝離術を行った2例

Two cases of laparoscopy-assisted endoscopic submucosal dissection （LA-ESD） for superficial duodenal neoplasm

◆要旨：症例1：79歳，男性．スクリーニングの上部消化管内視鏡で十二指腸に10mm大の0-IIa病変を認め，十二指腸癌の診断で腹腔鏡補助下内視鏡的粘膜剝離術（laparoscopy-assisted endoscopic submucosal dissection :以下，LA-ESD）を行った．症例2：62歳，男性．健診の上部消化管造影検査で胃腫瘍を認め，精査の上部消化管内視鏡で十二指腸下行脚外側に5mm大の0-IIa＋IIc病変を認め，悪性を否定できずLA-ESDを行った．2症例とも病理所見では十二指腸癌（tub1・pT1a）であった．早期十二指腸癌に対して安全にLA-ESDを施行しえた2症例を経験したので報告する．

　Case 1 : The patient was a 79-year-old male. Upper gastrointestinal endoscopic screening revealed an approximately 10-mm 0-IIa lesion in the duodenum that was diagnosed as duodenal cancer. Laparoscopy-assisted endoscopic submucosal dissection (LA-ESD) was conducted for the treatment of superfical duodenal neoplasm. Case 2 : The patient was a 62-year-old male. After performing an upper gastrointestinal series, he was diagnosed with a possible malignant gastric tumor (0-IIa ＋ IIc lesion, approximately 10mm) at the lateral side of the descending portion of the duodenum. LA-ESD was conducted for its treatment. Pathological findings showed duodenal cancer (tub1/pT1a) in both cases. We report our experience of these 2 patients who were safely treated with LA-ESD for superficial duodenal neoplasm.