title: [In Process Citation].
abstract: A 35-year-old female presented with epigastric symptoms and fatigue. Gastroscopy revealed a 2 cm ulcerated lesion in the antrum region. Biopsy confirmed an invasive intestinal type adenocc. Staging CT and EUS: cT2cN0cM0. Laparoscopic subtotal gastric resection + modified D2 lymphadenectomy was performed with Roux-en-Y reconstruction of the alimentary tract. Mobilisation of the duodenum and stomach was performed with a 5 mm Ligasure. Distal and proximal resection was performed using Endo GIA 60 mm staplers. We performed a modified D1 lymphadenectomy including the region of the coeliac axis, splenic artery and the hepato-duodenal ligament. A side-to-side retrocolic loop gastro-jejunostomy was fashioned using Endo GIA. To transform the loop jejunostomy to a Roux-n-Y setting, the efferent loop of the jejunum was divided using Endo GIA, while the open end of the stomach was sealed with this same stapler line. This way, the loop anastomosis was fashioned into Roux-Y. The end-to-side jejuno-jejunostomy component of the Roux-Y anastomosis was performed through the specimen extraction site with hand-sewn technique. Duration of surgery: 200 min. Blood loss: 100 ml. The postop period was uneventful, and the patient was discharged on day 9.
  
  
  RESULTS
  Invasive intestinal type adenocc., 27 mm diameter, pT1bpN0, HER2 2+.
  
  
  CONCLUSIONS
  Laparoscopic subtotal gastric resection with Roux-Y reconstruction is feasable without oncologic compromise and with excellent functional results in early gastric cancer.
authors.affiliation: Daganatsebészeti Centrum, Általános Sebészeti Osztály, Országos Onkológiai Intézet 1122 Budapest, Ráth György u. 7-9.
authors.forename: Tamás
authors.initials: T
authors.lastname: Sztipits
authors.affiliation: Daganatsebészeti Centrum, Általános Sebészeti Osztály, Országos Onkológiai Intézet 1122 Budapest, Ráth György u. 7-9.
authors.forename: Péter
authors.initials: P
authors.lastname: Mészáros
authors.affiliation: Daganatsebészeti Centrum, Általános Sebészeti Osztály, Országos Onkológiai Intézet 1122 Budapest, Ráth György u. 7-9.
authors.forename: Zsolt
authors.initials: Z
authors.lastname: Dubóczki
authors.affiliation: Invazív Gasztroenterológiai Részleg, Országos Onkológiai Intézet, Daganatsebészeti Centrum Budapest.
authors.forename: Ádám
authors.initials: Á
authors.lastname: Tarpay
authors.affiliation: Daganatsebészeti Centrum, Általános Sebészeti Osztály, Országos Onkológiai Intézet 1122 Budapest, Ráth György u. 7-9.
authors.forename: Tamás
authors.initials: T
authors.lastname: Mersich
keywords: Roux-en-Y; Roux-en-Y rekonstrukció; korai gyomorrák; laparoscopic subtotal gastric resection; laparoscopos subtotalis gyomorresectio; rearly gastric cancer