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<p>Here, we report a case of scar perforation caused by endoscopic dilation while the patient was waiting for additional gastrectomy after non-curative endoscopic submucosal dissection (ESD) for early gastric cancer. Although conservative treatment prevented the progression of generalized peritonitis, one-stage meticulous surgery was contraindicated because of abscess formation around the pylorus, which is the main target of lymphatic dissection. Therefore, we performed a two-stage surgery. Prior laparoscopic gastrojejunal bypass for peritonitis control and nutritional management allowed for uncompromised curative gastrectomy using a robotic approach. Among the various treatment strategies, our selected two-stage surgery was useful in achieving uncompromised cancer surgery in patients with perforated peritonitis after noncurative ESD, where prophylactic dissection was the primary objective.</p>

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Two-stage robotic gastrectomy after bypass surgery for a perforated non-curative endoscopic submucosal dissection scar: a case report

  • 期刊论文

  • 发表日期：

    2025年4月22日

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  • Makoto Hikage,
  • Taeko Matsuura,
  • Keiichiro Kawamura,
  • Masato Yamada,
  • Takuya Jimbo,
  • Munetaka Hashimoto,
  • Shunsuke Shibuya,
  • Yasushi Ito,
  • Kazuyuki Kusuda,
  • Yuji Goukon

摘要

Here, we report a case of scar perforation caused by endoscopic dilation while the patient was waiting for additional gastrectomy after non-curative endoscopic submucosal dissection (ESD) for early gastric cancer. Although conservative treatment prevented the progression of generalized peritonitis, one-stage meticulous surgery was contraindicated because of abscess formation around the pylorus, which is the main target of lymphatic dissection. Therefore, we performed a two-stage surgery. Prior laparoscopic gastrojejunal bypass for peritonitis control and nutritional management allowed for uncompromised curative gastrectomy using a robotic approach. Among the various treatment strategies, our selected two-stage surgery was useful in achieving uncompromised cancer surgery in patients with perforated peritonitis after noncurative ESD, where prophylactic dissection was the primary objective.