腹腔鏡下大網被覆術後２期的に根治術を施行した胃癌穿孔の１例

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  • PERFORATED GASTRIC CARCINOMA TREATED WITH LAPAROSCOPIC OMENTAL PATCH REPAIR FOLLOWED BY OPEN RADICAL SURGERY-REPORT OF A CASE

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We have experienced a patient with perforated gastric carcinoma successfully treated by a two-step surgery which included laparoscopic omental patch repair with peritoneal lavage for diffuse peritonitis and additional radical gastrectomy against advanced gastric carcinoma.<br> A 49-year-old woman was urgently admitted to the hospital because of severe abdominal pain. Under the diagnosis of diffuse peritonitis due to peptic ulcer perforation, laparoscopic comental patch repair with peritoneal lavage for diffuse peritonitis was performed at first. Since endoscopic examination on post-operative day (POD) 6 confirmed the diagnosis of advanced gastric carcinoma, additional radical gastrectomy with lymph node dissection was applied to the patient on POD 19 from the preceded laparoscopic surgery.<br> This two-stage radical gastrectomy with a preceding laparoscopic surgery for perforated gastric carcinoma may be effective because the preceding laparoscopic surgery can be less invasive and can make rapid recovery from critical condition caused by diffuse peritonitis.

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