幽門下動脈および迷走神経腹腔枝を温存する腹腔鏡補助下幽門保存胃切除術

Laparoscopy assisted pylorus-preserving gastrectomy with preservation of the vagus nerve and infrapyloric artery

　最近，早期胃癌に対し，術後の消化機能を考慮して幽門下動脈および迷走神経を温存する幽門保存胃切除術が試みられている．われわれはこの術式を腹腔鏡下に施行した．幽門下動脈および迷走神経の温存は腹腔鏡下でも容易であり，拡大視効果によってリンパ節郭清を損ねることなく施行できた．機能の温存によって周術期の侵襲を軽減するだけでなく，長期的な患者のquality of life（QOL）を考慮した術式と考えられた．

Recently pylorus-preserving gastrectomy with preservation of the vagus nerve and infrapyloric artery has been applied for the purpose of preventing postgastrectomy syndrome. We performed this procedure with laparoscopy for a patient with early gastric cancer. It was not difficult preserving the vagus nerve and infrapyloric artery during radical lymphnode dissection thanks to the good magnification of endoscopy. This procedure is an excellent option because of its reduced surgical invasiveness and better postoperative quality of life.