Residual gastric cancer above the suture line that was successfully resected en bloc by ESD

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  • Tanaka Masami
    Department of Gastroenterology, Akiru Municipal Medical Center
  • Shibuya Shinji
    Department of Gastroenterology, Akiru Municipal Medical Center
  • Hayama Jo
    Department of Gastroenterology, Akiru Municipal Medical Center
  • Okano Noriyoshi
    Department of Gastroenterology, Akiru Municipal Medical Center

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  • 縫合線上の残胃癌に対してESDで一括切除できた症例

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<p>A male in his 70s had undergone pyloric gastrectomy for gastric cancer more than 20 years ago. Endoscopy was performed for postoperative follow-up of the gastric cancer, and a 25 mm IIc lesion was found on the suture line of the residual gastric lesser curvature. Biopsy showed a well-differentiated adenocarcinoma (tub1). Endoscopic submucosal dissection (ESD) was performed under general anesthesia. The dissection proceeded to the layer where we could recognize the staple was removed. The lesion was resected en bloc. The pathological findings were 25×24 mm, tub1, SM1 (350 μm), ly0, v0, HM0, VM0.</p><p>Gastric cancer often occurs in the residual stomach after gastric cancer surgery. ESD is often difficult because the residual stomach is prone to bleeding, and endoscopic manipulation is so poor. In addition, ESD is more difficult with lesions on the suture line because of staples. It should be performed by an expert endoscopist.</p>

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