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Esophagogastric Reconstruction in Cobra-Head Shape with Toupet-Like Partial Anti-Reflux Technique for Resection of Proximal Gastric Tumors. Experience with Three Cases from a Non-Asian Population

Esophagogastric Reconstruction in Cobra-Head Shape with Toupet-Like Partial Anti-Reflux Technique for Resection of Proximal Gastric Tumors. Experience with Three Cases from a Non-Asian Population

作     者:Alberto M. León-Takahashi Ana P. Meléndez-Fernández Leonardo S. Lino-Silva Horacio N. López-Basave Rosa Angelica Salcedo Hernandez César Zepeda-Najar Ángel Herrera-Gómez Alberto M. León-Takahashi;Ana P. Meléndez-Fernández;Leonardo S. Lino-Silva;Horacio N. López-Basave;Rosa Angelica Salcedo Hernandez;César Zepeda-Najar;Ángel Herrera-Gómez

作者机构:Surgical Oncology National Cancer Institute (México) Mexico City Mexico Surgical Pathology National Cancer Institute (México) Mexico City Mexico Surgical Oncology ángeles Hospital Tijuana Mexico 

出 版 物:《Open Journal of Gastroenterology》 (肠胃病学期刊(英文))

年 卷 期:2023年第13卷第4期

页      面:149-160页

学科分类:1002[医学-临床医学] 100214[医学-肿瘤学] 10[医学] 

主  题:GIST Gastric Cancer Laparoscopy Proximal Gastrectomy Cobra Head Reconstruction 

摘      要:Background: Proximal gastrectomy is a rarely performed procedure but a feasible option in benign tumors and malignant neoplasms in the proximal third of the stomach since novel options of reconstructions are available nowadays with fewer long-term sequels. Methods: Report of three cases of proximal gastric gastrointestinal stromal tumors (GIST), with a description of its presentation, histological characteristics, and follow-up after being treated with proximal gastrectomy with cobra head reconstruction. Results: Case 1: A 62-year-old woman with epigastric pain of four months with endoscopic evidence of a cardia GIST. The surgery was performed without complications. The histopathological report confirmed a fusiform GIST of 3.2 × 3 × 2.5 cm, stage IA. No adjuvant treatment was considered. An esophagogram showed no evidence of reflux and no stenosis, and no disease recurrence after 40-months follow-up. Case 2: A 66-year-old woman with dyspepsia and a palpable tumor in the epigastrium. The surgery was performed without complications. The pathology report confirmed a proximal gastric GIST of 13 × 8 × 7 cm, staged II. She received adjuvant treatment with imatinib for 36 months without recurrence and no reflux or stenosis. Case 3: A 55-year-old woman with intermittent hematemesis and right subscapular pain. The surgery was performed without complications. The histopathological report concluded that a GIST tumor of the cardia, 1.4 × 1.2 cm, staged IA. She was left in observation. At a 6-month follow-up, she does not report dysphagia, reflux, or stenosis, and no locoregional recurrence. Conclusions: Open and laparoscopic proximal gastrectomy is a safe therapeutic option for GIST. Furthermore, the reconstruction of the esophagus-gastro anastomosis in the cobra head after proximal gastrectomy is feasible and secure in our population, with good functional results in a short follow-up.

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