腹腔镜胃切除术治疗残胃癌的腹腔镜全切除术

                               
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Salvage Laparoscopic Total Gastrectomy for Gastric Remnant Cancer

Ashamalla SM and Stotland PK.


Reported rates of gastric remnant cancer range from 1 to 8% in patients who have had prior gastric resection. Patients with a Billroth II anastomosis are at increased risk of developing remnant carcinoma due to chronic irritation from biliary, pancreatic, and duodenal reflux into the gastric remnant. There are limited reports in the literature describing the surgical treatment for this condition but none address a laparoscopic approach. We describe a salvage laparoscopic total gastrectomy with intracorporeal roux-en-y esophago-jejunal anastomosis for a bleeding gastric remnant adenocarcinoma 60 years after initial surgery for PUD. This video demonstrates the steps in performing a salvage total gastrectomy after previous distal gastrectomy. Key steps of the procedure, including: small bowel mesentery lymphadenectomy and complete intracorporeal circular end-to-side anastomosis are shown.