A case of early remnant gastric cancer successfully treated by non-exposed endoscopic wall-inversion surgery Hiroshi KOBAYASHI 1,2 , Michitaka HONDA 1,2 , Mitsuru WARAGAI 2 , Akinao KANETA 2 , Hidetaka KAWAMURA 1,2 , Yukitoshi TODATE 1,2 1Department of Minimally Invasive Surgical and Medical Oncology, Fukushima Medical University 2Department of Surgery, Southern Tohoku General Hospital Keyword: 残胃癌 , LECS , NEWS pp.44-48
Published Date 2020/1/15
DOI https://doi.org/10.11477/mf.4426200770
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 A 74-year-old man was referred to our hospital for treatment of early remnant gastric cancer. The patient had undergone distal gastrectomy with Billroth I reconstruction 14 years ago. Gastrointestinal endoscopy showed a superficial depressed type (0-IIc) lesion located in his remnant stomach. Biopsy was performed and pathological result was well-differentiated adenocarcinoma. Non-exposed endoscopic wall-inversion surgery (NEWS) was planned because the scar around the tumor was too hard for endoscopic submucosal dissection (ESD). Adhesions around the remnant stomach was separated laparoscopically, exposing the serosal surface of the lesion. After marking the lesion under endoscopy, a circumferential seromuscular layer cutting was performed, inverting the lesion into the stomach, and suturing the seromuscular layer laparoscopically. Finally, the lesion was completely resected using ESD. There has been no evidence of recurrence or any complaints from the patient, 17 months after surgery.

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