Totally laparoscopic gastrectomy for early gastric cancer accompanied by huge hiatal hernia: A case report

Abstract

We herein present a case in which we used a totally laparoscopic approach for early gastric cancer accompanied by a huge hiatal hernia. An 80-year-old Japanese woman was referred with a chief complaint of dysphagia. A clinical diagnosis of early gastric cancer, T1b (SM) N0M0, stage IA, accompanied by hiatal hernia, was made. Distal gastrectomy with D1 plus lymphadenectomy was carried out. After the gastrectomy, the hernial sac was excised and the hernial orifice was closed. Reconstruction using the Roux-en-Y method was selected. The postoperative course was uneventful and she was discharged on postoperative day 10.

Simultaneous laparoscopic hiatal hernia repair and pyloroplasty for a type 3 hiatal hernia with post‐ESD pyloric stenosis for early gastric cancer

“… 3 Hagiwara et al reported on five patients who underwent laparoscopic gastrectomy for gastric cancer accompanied by huge hiatal hernia. 2 In this case, preoperative endoscopic examination revealed an EGC for an ESD adaptation. Endoscopic treatment or surgery must be selected according to the gastric cancer stage; hence, it is necessary to check for malignant diseases such as esophageal and gastric cancer before surgery for an esophageal hiatal hernia.…”

“…Mimatsu et al reported the clinicopathological characteristics, treatment, and outcomes of 14 patients with gastric cancer from the upside‐down stomach through a paraesophageal hernia 3 . Hagiwara et al reported on five patients who underwent laparoscopic gastrectomy for gastric cancer accompanied by huge hiatal hernia 2 . In this case, preoperative endoscopic examination revealed an EGC for an ESD adaptation.…”

“…Hiatal hernia is a common disorder of diaphragmatic hernia. 1 Gastric cancer with esophageal hiatal hernia has been reported; 2 , 3 , 4 however, reports of early gastric cancer (EGC) treated with endoscopic submucosal dissection (ESD) in the pylorus, including a hiatal hernia are lacking. Because of the low invasiveness and almost no lymph node metastasis in EGC with an ESD adaptation, endoscopic treatment is recommended.…”

Diaphragmatic Hernia After Totally Laparoscopic Total Gastrectomy for Gastric Cancer

“…12 Diaphragmatic hernia (DH) is an iatrogenic condition in which the abdominal contents herniate into the thoracic space through the hiatus. 13 Although DH is a rare complication of IH after TLTG, it merits concern because this hernia can dramatically present as an acute bowel obstruction with bowel necrosis. Especially, delayed surgical intervention may result in bowel perforation with high morbidity and mortality.…”