腹腔镜根治性全胃切除术  

Laparoscopic radical total gastrectomy

作　　者：余佩武[1] 赵永亮[1] 

机构地区：[1]第三军医大学西南医院普通外科微创外科中心,重庆400038

出　　处：《中华普外科手术学杂志（电子版）》2015年第2期22-22,共1页Chinese Journal of Operative Procedures of General Surgery(Electronic Edition)

基　　金：重庆市科技攻关项目(CSTC2012ggyyjs10029)~~

摘　　要：患者,男性,56岁。因乏力1个月,呕血18天入院。体检:锁骨上淋巴结未触及肿大,上腹部轻压痛,未扪及包块,移动性浊音(-)。直肠指检:直肠黏膜光滑,未触及异常包块。胃镜检查:贲门小弯侧及后壁可见病灶,周围黏膜隆起呈结节状。CT检查:食管胃连接区不均匀增厚,明显强化,第3组淋巴结增大。在全麻下行腹腔镜根治性全胃切除术,消化道重建采用Roux-en-Y吻合,腔镜下经食管放置抵钉座,食管空肠吻合采用我们自行设计的半端端吻合方式。术后病理:癌组织侵犯至浆膜下层。手术标本近、远切缘及送检网膜均未见癌组织。诊断:食管胃结合部低分化腺癌伴淋巴结转移5/35。术后TNM分期:T3N2M0,ⅢA期。The patient we persent here was a 56-year-old man. He has had fatigue for a month and was admitted to the hospital at the 18th day of hematemesis. Gastroscopy showed that lesions located on the small curved side and rear the walls of the gastric cardia and swelling node in mucosa around the lesions. CT examination showed that irregular hypertrophy in esophagogastric junction, contrast-enhanced CT examination results, enlargement of the 3th group of lymph nodes. The patients underwent laparoscopic total gastrectomy and Roux-en-Y gastrointestinal reconstruction with a semi-end-to-side esophagojejunal anastomosis. Postoperative pathological diagnosis included tumor invaded subserosa; all resection margins were negative. Postoperative diagnosis was made of esophagogastric junction poor-differentiated adenocarcinoma with lymph node metastasis in 5/35. Postoperative TNM stage： T3N2M0, ⅢA

关 键 词：胃肿瘤 腹腔镜检查 全胃切除术 

分 类 号：R656.6[医药卫生—外科学]