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開催概要
開催回
第56回・2018年・横浜
 

胃癌術後腹膜診断における審査腹腔鏡検査の安全性と有効性について

演題番号 : P9-7

[筆頭演者]
演者)竹野 淳:1 
[共同演者]
益澤 徹:1、村上 剛平:1、河合 賢二:1、阪本 卓也:1、稲留 遵一:1、内藤 敦:1、桂 宜輝:1、大村 仁昭:1、賀川 義規:1、柄川 千代美:1、武田 裕:1、村田 幸平:1

1:関西労災病院・外科

 

Introduction)
We often suffer to decide treatment strategy for peritoneal recurrences of gastric cancer after gastrectomy because of difficulty of early detection of peritoneal recurrences. To develop a better modality for early detection of peritoneal recurrences is urgent need. This retrospective study evaluated feasibility and usefulness of staging laparoscopy (SL) for peritoneal recurrences of gastric cancer after gastrectomy.
Methods)
SL was conducted for 18 patients who underwent gastrectomy for gastric cancer between 2013 and 2017. They had no clinical evidence of distant metastases and were suspected of peritoneal recurrences based on some reasons.
Results)
The median interval between initial surgery and SL was 22.9 (9-62) months. At the initial surgery, 12 patients underwent total gastrectomy and 6 underwent distal gastrectomy. Seventeen patients were given adjuvant chemotherapy. Most of the reasons for SL were elevation of tumor markers. SL procedures enabled all patients to be examined into abdominal cavity and get peritoneal washing cytology. No patients required to laparotomy and experienced postoperative complications. SL found 6 patients to have peritoneal metastases and 7 patients to have positive cytology by pathological examination. The information of SL helped 7 patients to change therapeutic measures. (Six patients initiated systemic chemotherapy and 1 patients underwent bypass surgery.)Six of 11 patients who turned out without peritoneal recurrences by SL suffered some recurrence. However, no one resulted in peritoneal recurrences.
Conclusions)
SL after gastrectomy was a safe and promising modality to assess and manage peritoneal recurrences of gastric cancer.

キーワード

臓器別:胃・十二指腸

手法別:手術療法

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