PHẪU THUẬT NỘI SOI Ổ BỤNG KẾT HỢP NỘI SOI TIÊU HÓA CÙNG VỚI SINH THIẾT HẠCH CANH GÁC TRONG UNG THƯ SỚM DẠ DÀY: BÁO CÁO HÀNG LOẠT CA

Abstract

Introduction: Gastric cancer is still a heavy burden in East Asian countries, including Vietnam, Japan, South Korea and China [1]. Notably, early gastric cancer (EGC) carries a more favorable prognosis [2]. In the treatment of even these early tumors, the gold standard is the complete removal of the malignant cells. In addition, the patient's quality of life (QoL) after these procedures must be taken into consideration. Methods: Three consecutive patients with EGC underwent LECS plus SNNS at our hospital. At least four lymphatic basins were harvested and examined intraoperatively with frozen section analysis to assess lymph node status and resection margins. Clinical features, surgical outcomes, and postoperative events were recorded. Results: All three procedures were successfully completed without conversion to open surgery. Frozen sections confirmed negative sentinel node metastasis and R0 resections with circumferential margins ≥1 cm. Follow-up periods were 21, 13, and 12 months, respectively, with no recurrence observed. One patient developed gastric stricture on postoperative day 16, which was treated conservatively with full recovery. Conclusion: LECS combined with SNNS is a feasible and safe minimally invasive approach for EGC, ensuring oncologic safety while preserving gastric function. This technique may serve as an effective alternative to standard gastrectomy, particularly when endoscopic submucosal dissection is insufficient. Careful intraoperative endoscopy is essential to detect and manage postoperative complications such as stricture.