title: Hybrid Natural Orifice Transluminal Endoscopic Surgery with Sentinel Lymph Node Navigation for Deep Early Gastric Cancer in the Fundic Region.
abstract: For patients refusing surgical treatment for deep early gastric cancer, hybrid natural orifice transluminal endoscopic surgery with sentinel lymph node navigation is a potential treatment option, particularly when the anatomic location of the cancer has low probability of lymph node metastasis. We report a case of deep early gastric cancer of the fundus beyond the endoscopic submucosal dissection indication that was treated by hybrid natural orifice transluminal endoscopic surgery with sentinel lymph node navigation. In a conventional approach, a total gastrectomy would have been needed; however, the patient refused surgical intervention. In this case, since the patient showed no positivity of the sentinel lymph node on intraoperative navigation, laparoscopic basin lymph node dissection was not performed. Hybrid natural orifice transluminal endoscopic surgery might be considered for specific regions such as the safety zone where lymph node metastases are less likely to occur.
authors.affiliation: Department of Internal Medicine, Eulji General Hospital, Eulji University School of Medicine, Seoul, Korea.
authors.forename: Yoon Suk
authors.initials: YS
authors.lastname: Park
authors.affiliation: Department of Internal Medicine, Eulji General Hospital, Eulji University School of Medicine, Seoul, Korea.
authors.forename: Seong Hwan
authors.initials: SH
authors.lastname: Kim
authors.affiliation: Department of Internal Medicine, Eulji General Hospital, Eulji University School of Medicine, Seoul, Korea.
authors.forename: Hee Yun
authors.initials: HY
authors.lastname: Ryu
authors.affiliation: Department of Internal Medicine, Eulji General Hospital, Eulji University School of Medicine, Seoul, Korea.
authors.forename: Young Kwan
authors.initials: YK
authors.lastname: Cho
authors.affiliation: Department of Internal Medicine, Eulji General Hospital, Eulji University School of Medicine, Seoul, Korea.
authors.forename: Yun Ju
authors.initials: YJ
authors.lastname: Jo
authors.affiliation: Department of Surgery, Eulji General Hospital, Eulji University School of Medicine, Seoul, Korea.
authors.forename: Tae Il
authors.initials: TI
authors.lastname: Son
authors.affiliation: Department of Pathology, Eulji General Hospital, Eulji University School of Medicine, Seoul, Korea.
authors.forename: Young Ok
authors.initials: YO
authors.lastname: Hong
keywords: Lymphatic metastasis; Natural orifice endoscopic surgery; Stomach neoplasms