{"created":"2023-05-15T11:24:13.601154+00:00","id":4009,"links":{},"metadata":{"_buckets":{"deposit":"81869e5d-2872-4342-a205-fd1c529ea7cb"},"_deposit":{"created_by":1,"id":"4009","owners":[1],"pid":{"revision_id":0,"type":"depid","value":"4009"},"status":"published"},"_oai":{"id":"oai:showa.repo.nii.ac.jp:00004009","sets":["1:6:353:355"]},"author_link":["13392","13398","13393","13395","13401","13397","13400","13399","13394","13396"],"item_10002_biblio_info_7":{"attribute_name":"書誌情報","attribute_value_mlt":[{"bibliographicIssueDates":{"bibliographicIssueDate":"2022-03"},"bibliographicIssueNumber":"1","bibliographicPageEnd":"25","bibliographicPageStart":"19","bibliographicVolumeNumber":"82","bibliographic_titles":[{"bibliographic_title":"昭和学士会雑誌"}]}]},"item_10002_description_6":{"attribute_name":"抄録","attribute_value_mlt":[{"subitem_description":"93歳女性．黒色便・食思不振に対し上部消化管内視鏡を施行．胃体中部から前庭部に約半周性の4型病変を認め，生検で粘液腺癌であった．CT検査では縦隔内へ全胃の脱出を認め，複数個の所属リンパ節腫大を認めたが，明らかな遠隔転移は認めなかった．超高齢かつ著しい裂孔ヘルニア併存のため，残胃の縦郭内嵌入を回避すべく単純胃全摘の術前方針とした．腹腔鏡所見では腹膜播種を認めたものの，全胃が腹腔内に還納できたため胃全摘可能と判断し開腹移行とした．しかし開腹下では著しい亀背のため視野不良であり，腹部食道周囲の操作は危険と判断し胃亜全摘術に変更．裂孔内への再嵌入と胃内容排出遅滞（DGE）の回避を目的として，残胃を胃管のように細長く形成して腹側・尾側に牽引し，頭側から尾側へ縦方向に固定すべく腹壁と縫合した．術後経過は良好で，DGE・ダンピング症候群も見られる事なく速やかに全粥摂取可能となったため，第9病日退院許可に至った．超高齢者に対し残胃を縦方向に固定することにより意図的にDGEを防止し，さまざまな術後早期合併症を回避し得た症例を経験したので報告する．","subitem_description_type":"Abstract"}]},"item_10002_publisher_8":{"attribute_name":"出版者","attribute_value_mlt":[{"subitem_publisher":"昭和大学学士会"}]},"item_10002_relation_14":{"attribute_name":"DOI","attribute_value_mlt":[{"subitem_relation_type_id":{"subitem_relation_type_id_text":"10.14930/jshowaunivsoc.82.19"}}]},"item_10002_source_id_9":{"attribute_name":"ISSN","attribute_value_mlt":[{"subitem_source_identifier":"2188-529X"}]},"item_10002_version_type_20":{"attribute_name":"著者版フラグ","attribute_value_mlt":[{"subitem_version_type":"VoR"}]},"item_creator":{"attribute_name":"著者","attribute_type":"creator","attribute_value_mlt":[{"creatorNames":[{"creatorName":"石田, 幸子"}],"nameIdentifiers":[{}]},{"creatorNames":[{"creatorName":"加藤, 博久"}],"nameIdentifiers":[{}]},{"creatorNames":[{"creatorName":"仁科, 晴弘"}],"nameIdentifiers":[{}]},{"creatorNames":[{"creatorName":"高野, 弓加"}],"nameIdentifiers":[{}]},{"creatorNames":[{"creatorName":"堀江, 智子"}],"nameIdentifiers":[{}]},{"creatorNames":[{"creatorName":"伊達, 博三"}],"nameIdentifiers":[{}]},{"creatorNames":[{"creatorName":"小池, 礼子"}],"nameIdentifiers":[{}]},{"creatorNames":[{"creatorName":"青木, 武士"}],"nameIdentifiers":[{}]},{"creatorNames":[{"creatorName":"横山, 登"}],"nameIdentifiers":[{}]},{"creatorNames":[{"creatorName":"井上, 晴洋"}],"nameIdentifiers":[{}]}]},"item_files":{"attribute_name":"ファイル情報","attribute_type":"file","attribute_value_mlt":[{"accessrole":"open_date","date":[{"dateType":"Available","dateValue":"2022-04-04"}],"displaytype":"detail","filename":"82_19.pdf","filesize":[{"value":"871.1 kB"}],"format":"application/pdf","licensetype":"license_note","mimetype":"application/pdf","url":{"label":"82_19.pdf","url":"https://showa.repo.nii.ac.jp/record/4009/files/82_19.pdf"},"version_id":"9556f008-1774-4848-8074-e398a9e3638e"}]},"item_language":{"attribute_name":"言語","attribute_value_mlt":[{"subitem_language":"jpn"}]},"item_resource_type":{"attribute_name":"資源タイプ","attribute_value_mlt":[{"resourcetype":"departmental bulletin paper"}]},"item_title":"残胃固定により胃内容排出遅延防止を図った巨大食道裂孔ヘルニアを伴う超高齢者進行胃癌の1切除例","item_titles":{"attribute_name":"タイトル","attribute_value_mlt":[{"subitem_title":"残胃固定により胃内容排出遅延防止を図った巨大食道裂孔ヘルニアを伴う超高齢者進行胃癌の1切除例"}]},"item_type_id":"10002","owner":"1","path":["355"],"pubdate":{"attribute_name":"公開日","attribute_value":"2022-04-04"},"publish_date":"2022-04-04","publish_status":"0","recid":"4009","relation_version_is_last":true,"title":["残胃固定により胃内容排出遅延防止を図った巨大食道裂孔ヘルニアを伴う超高齢者進行胃癌の1切除例"],"weko_creator_id":"1","weko_shared_id":-1},"updated":"2023-05-15T11:54:56.713597+00:00"}