胃癌術後に腹腔鏡・内視鏡合同胃局所切除術を施行した残胃GISTの1例

Laparoscopic and endoscopic cooperative surgery for gastrointestinal stromal tumor of the remnant stomach after distal gastrectomy for gastric cancer: A case report

◆要旨：症例は56歳，女性．13年前に早期胃癌で幽門側胃切除術（Billroth-1法再建）の開腹歴がある．毎年受けている上部消化管内視鏡検査で残胃体上部後壁に20mm大の粘膜下腫瘍を指摘され，胃消化管間質腫瘍の術前診断で，腹腔鏡・内視鏡合同胃局所切除術を施行した．合併症等はなく術後7日目に退院した．術後2年間再発や後遺症などなく経過している．胃癌術後の残胃消化管間質腫瘍に対し，高度の癒着にもかかわらず噴門を温存して腹腔鏡・内視鏡合同手術による胃局所切除術を遂行しえた．

　The case was a 56-year-old woman. She had a past history of distal gastrectomy （Billroth-1 reconstruction）for early gastric cancer 13 years ago. An annual esophagogastroduodenoscopy revealed a 20 mm-size submucosal tumor on the upper posterior wall of the remnant stomach, and a laparoscopic and endoscopic cooperative surgery was performed for a diagnosis of gastrointestinal stromal tumor. She was discharged from the hospital on the 7th postoperative day without any complications. The patient has passed without recurrence or sequelae for 2 years after the operation. For the gastrointestinal stromal tumor of the remnant stomach after gastric cancer operation, the cardia was preserved despite advanced adhesion, and local resection of the stomach by laparoscopic and endoscopic cooperative surgery was carried out successfully.