胃内外発育型ＧＩＳＴに対し漿膜筋層切開法を用いて胃局所切除術を施行した１例

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  • LOCAL GASTRIC RESECTION WITH SEROMYOTOMY FOR A GASTROINTESTINAL SUBMUCOSAL TUMOR OF THE STOMACH WITH INTRA-AND EXTRAGASTRIC GROWTH-A CASE REPORT-

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A 68-year-old man was seen at the emergency department in our hospital because of the sudden onset of hematemesis. Endoscopic examination revealed a submucosal tumor with ulceration at the middle body of the stomach. Upper gastrointestinal series showed extramural displacement of the lesser curvature of the stomach by extragastric part of the tumor. Contrast-enhanced CT scan of the abdomen showed a heterogeneously enhanced mass measuring 13cm in maximum diameter adjacent to the anterior wall of the stomach. These findings offered a diagnosis of gastrointestinal submucosal tumor with intra-and extragastric growth, and we performed local gastric resection. During the operation, we added seromyotomy of the gastric wall around the tumor in order to bring the intragastric part of the tumor outside, which enabled us to make full-thickness resection with necessity minimum margin. Surgical margins were free from neoplastic component on pathological examination. Neither deformity of the residual stomach nor passage disorder was found after the surgery. This procedure achieves both the radicality and good quality of life. Besides, it can be performed without special devices or techniques. We regard it as beneficial one, and look for its popularization.

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