CAJ | 학술논문

患者，男性，56岁。因乏力1个月，呕血18天入院。体检：锁骨上淋巴结未触及肿大，上腹部轻压痛，未扪及包块，移动性浊音（－）。直肠指检：直肠黏膜光滑，未触及异常包块。胃镜检查：贲门小弯侧及后壁可见病灶，周围黏膜隆起呈结节状。 CT检查：食管胃连接区不均匀增厚，明显强化，第3组淋巴结增大。在全麻下行腹腔镜根治性全胃切除术，消化道重建采用Roux-en-Y吻合，腔镜下经食管放置抵钉座，食管空肠吻合采用我们自行设计的半端端吻合方式。术后病理：癌组织侵犯至浆膜下层。手术标本近、远切缘及送检网膜均未见癌组织。诊断：食管胃结合部低分化腺癌伴淋巴结转移5／35。术后TNM分期：T3N2M0，ⅢA期。
환자，남성，56세。인핍력1개월，구혈18천입원。체검：쇄골상림파결미촉급종대，상복부경압통，미문급포괴，이동성탁음（－）。직장지검：직장점막광활，미촉급이상포괴。위경검사：분문소만측급후벽가견병조，주위점막륭기정결절상。 CT검사：식관위련접구불균균증후，명현강화，제3조림파결증대。재전마하행복강경근치성전위절제술，소화도중건채용Roux-en-Y문합，강경하경식관방치저정좌，식관공장문합채용아문자행설계적반단단문합방식。술후병리：암조직침범지장막하층。수술표본근、원절연급송검망막균미견암조직。진단：식관위결합부저분화선암반림파결전이5／35。술후TNM분기：T3N2M0，ⅢA기。
The patient we persent here was a 56-year-old man.He has had fatigue for a month and was admitted to the hospital at the 18th day of hematemesis.Gastroscopy showed that lesions located on the small curved side and rear the walls of the gastric cardia and swelling node in mucosa around the lesions.CT examination showed that irregular hypertrophy in esophagogastric junction, contrast-enhanced CT examination results, enlargement of the 3th group of lymph nodes.The patients underwent laparoscopic total gastrectomy and Roux-en-Y gastrointestinal reconstruction with a semi-end-to-side esophagojejunal anastomosis. Postoperative pathological diagnosis included tumor invaded subserosa; all resection margins were negative. Postoperative diagnosis was made of esophagogastric junction poor-differentiated adenocarcinoma with lymph node metastasis in 5 /35.Postoperative TNM stage:T3N2M0,ⅢA .