Laparoscopic lymph node biopsy in the hepatic hilum following endoscopic submucosal dissection for esophageal adenosquamous cell cancer and open total gastrectomy for gastric cancer :Report of a case Yusuke MAEDA 1,2 , Koichi SUDA 1,3 , Toshiyuki IWAGO 1 , Kunio MIZUGUCHI 4 , Kyosuke MAEDA 1 1Akasakamitsuke Maeda Hospital 2Department of Surgery, Saiseikai Central Hospital 3Department of Gastroenterological Surgery, Fujita Health University 4Department of Clinical Laboratory Science, Teikyo University School of Medicine, Mizoguchi Hospital Keyword: 腹腔鏡下生検 , 肝門部リンパ節 , 開腹胃全摘後 pp.515-521
Published Date 2019/11/15
DOI https://doi.org/10.11477/mf.4426200754
  • Abstract
  • Look Inside
  • Reference

 We herein report a rare case of solitary hepatic hilar lymph node metastasis after endoscopic submucosal dissection for superficial esophageal adenosquamous cell cancer which was successfully diagnosed on laparoscopic lymph node biopsy. A seventy-four-year-old male, who underwent open total gastrectomy for advanced gastric cancer at the age of 41, underwent endoscopic submucosal dissection for superficial esophageal cancer (pT1b, ly0, v0). Any additional treatment was not performed according to the patient's request. Three months after ESD, CT scan showed an enlarged hepatic hilar lymph node measuring 18mm in size, in which FDG-PET demonstrated abnormal uptake. Laparoscopic lymph node biopsy was performed for the mass. Histological examination suggested recurrence of esophageal cancer. The postoperative course was uneventful. Based on the pathological diagnosis, this patient has been undergoing chemotherapy and surviving for 14 months after laparoscopic biopsy. Even in a patient with a history of open gastrectomy for advanced gastric cancer, hepatic hilar lymph node could be safely excised by tracing the virgin dissectable layer using laparoscopic magnified horizontal image in combination with mediolateral and/or caudocranial approach.

Copyright © 2019, JAPAN SOCIETY FOR ENDOSCOPIC SURGERY All rights reserved.


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