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conferenceseries
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Volume 7, Issue 4(Suppl)
J Gastrointest Dig Syst, an open access journal
ISSN: 2161-069X
Gastro Congress 2017
September 11-12, 2017
September 11-12, 2017 | Paris, France
12
th
Euro-Global Gastroenterology Conference
Multivisceral resection for advanced gastric cancer. Case report
Maksim A. Evseev
Volyn hospital, Russian Federation
I
n regard of permanent discussion about necessity and possibility of multi visceral resections in advanced malignancy, we present a
clinical case Multi visceral resection – total gastrectomy, pancreatoduodenal resection and the extended right colectomy.
A woman 39 years was examined about the violation of gastric emptying and symptoms of gastric bleeding, appeared 2 months prior
to treatment. After the examination stomach cancer (poorly differentiated adenocarcinoma, antrum and body, Borrmann III) with
the spread to duodenum, invasion of pancreatic head, with involvement of perigastral lymph node without distant metastases was
diagnosed. At intraoperative examination circular tumor of stomach with involvement of antrum, body, subcardia, spreading to
proximal part of duodenum and Invasion of pancreatic head, right flexure of the colon, right Para colon and mesocolon with middle
colic vessels, metastatic lesion of lymph node in groups 3, 4d - 7, 15 were detected (oT4N1M0, fT4N2M0 (R0)). Total gastrectomy,
pancreatoduodenectomy, extended right colectomy with regional lymphadenectomy D2-3 (lymph nodes of groups 1 - 13, 14v, 15,
16b1 were removed) were performed. Reconstructive phase of surgery included the formation of nutritional and biliopancreatic loops
of the small intestine by Y-en-Roux. In time of the alimentary loop formation esophagoenterostomy and Iliodescendostomy were
performed. In the biliopancreatic loop have been performed invaginated pancreaticoenterostomy and hepaticoenterostomy. Surgery
was completed insertion of transnasal feeding tube in the alimentary loop and 4 drainages in the abdominal cavity. Postoperative
period has been executed according to ERAS with enteral nutritional and physical activation at 1 day after surgery. There were
no complications in the postoperative period. Final diagnosis was. The patient was discharged on day 10 in a good condition for
adjuvant chemotherapy (XELOX). Within 12 months of observation after 6 months of the adjuvant treatment no local or metastatic
progression of tumor and no dyspeptic symptoms have been identified.
dr.maxim.evseev@gmail.comJ Gastrointest Dig Syst 2017, 7:4(Suppl)
DOI: 10.4172/2161-069X-C1-053