巨大裂孔ヘルニアを合併したバレット食道腺癌に対して胸腔鏡・腹腔鏡補助下 に食道裂孔ヘルニア修復と食道切除再建術を施行した1 例

Translated title of the contribution: Barrett esophageal adenocarcinoma with coexisting giant hiatal hernia, treated with simultaneous hiatal hernia repair and esophagectomy by thoracoscopic and laparoscopic approaches

Toshiaki Fukutomi, Hirofumi Ichikawa, Kazuaki Hatsugai, Masato Ohara, Shigeru Ottomo, Akefumi Sato, Atsushi Kohyama, Taiki Kajiwara, Yuko Itakura, Toru Takahashi

Research output: Contribution to journalArticlepeer-review

Abstract

We report a case of Barrett adenocarcinoma with coexisting giant hiatal hernia presenting an upside-down stomach (UDS). Hiatal hernia repair and Ivor-Lewis esophagectomy were simultaneously performed by laparoscopic and thoracoscopic approaches. A 68-year-old man was given a diagnosis of type IV hiatal hernia with UDS. Upper gastrointestinal endoscopy revealed an early-stage adenocarcinoma in the long-segment Barrett esophagus. The operation was initiated with laparoscopy. It took time to reposition the herniated stomach because of severe intrasaccular adhesion and the massive greater omentum occupying the sac. The stomach was mobilized and repositioned after adhesiolysis and partial resection of the omentum. The cardia was transected and the gastric conduit was prepared extracorporeally. Crural repair was performed by interrupted sutures and reinforced with a prosthetic mesh. Then, the thoracoscopic part was performed in the prone position. The thoracic esophagus was mobilized and the specimen was retrieved after transecting the esophagus at the level of the azygos arch. Esophagogastrostomy was created with an endoscopic linear stapler and hand-sewn closure of the entry hole. From the viewpoint of pulmonary function and securing the visual field in the sac, minimally invasive surgery was useful.

Translated title of the contributionBarrett esophageal adenocarcinoma with coexisting giant hiatal hernia, treated with simultaneous hiatal hernia repair and esophagectomy by thoracoscopic and laparoscopic approaches
Original languageJapanese
Pages (from-to)239-246
Number of pages8
JournalJapanese Journal of Gastroenterological Surgery
Volume52
Issue number5
DOIs
Publication statusPublished - 2019

ASJC Scopus subject areas

  • Surgery
  • Gastroenterology

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