A case of gastric adenocarcinoma of fundic gland type resected by combination of laparoscopic and endoscopic approaches to neoplasia with non-exposure technique (CLEAN-NET)

Motohiko Kato, Toshio Uraoka, Yoh Isobe, Keiichiro Abe, Tetsu Hirata, Yoshiaki Takada, Michiko Wada, Yusaku Takatori, Kaoru Takabayashi, Yoichi Fujiyama, Kousuke Sekiya, Yoshiki Kawaguchi, Aoi Sukeda, Junichi Shiraishi

Research output: Contribution to journalArticle

11 Citations (Scopus)

Abstract

A male in his eighties attended our hospital for further evaluation of gastric cancer. A gastroscopy revealed a whitish flat elevated lesion (Paris, 0-IIa) of 15 mm in diameter on the greater curvature of the proximal fornix. The preoperative diagnosis was intra-mucosal differentiated gastric cancer, and a novel therapeutic approach, combination of laparoscopic and endoscopic approaches to neoplasia with non-exposure technique (CLEAN-NET) was applied and the lesion was resected in a single piece without any complications. Histopathological findings revealed atypical glandular epithelium proliferated in the mucosa and shallow layer (300 μm) of submucosa. These cells stained positive for pepsinogen-I and the final diagnosis was gastric cancer of fundic gland type (GAFT). There was no lymph–vascular involvement and free horizontal and vertical margins were confirmed. CLEAN-NET could be a therapeutic option for GAFT at low risk of lymph node metastasis because it prevents excess wall defect and exposure of cancer cells into the peritoneal cavity.

Original languageEnglish
Pages (from-to)393-399
Number of pages7
JournalClinical Journal of Gastroenterology
Volume8
Issue number6
DOIs
Publication statusPublished - 2015 Dec 1
Externally publishedYes

Keywords

  • CLEAN-NET
  • Full-thickness resection
  • Fundic gland type
  • Gastric cancer
  • LECS

ASJC Scopus subject areas

  • Gastroenterology

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