Two resected cases of metachronous gastric cancer following gastric pull-up surgery for thoracic esophageal cancer

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  • KOBAYASHI Yoshie
    Department of Surgery, National Hospital Organization, Shikoku Cancer Center
  • NOZAKI Isao
    Department of Surgery, National Hospital Organization, Shikoku Cancer Center
  • KOBATAKE Takaya
    Department of Surgery, National Hospital Organization, Shikoku Cancer Center
  • OHTA Koji
    Department of Surgery, National Hospital Organization, Shikoku Cancer Center
  • KURITA Akira
    Department of Surgery, National Hospital Organization, Shikoku Cancer Center

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  • 胃管口側を残して有茎空腸再建を行った食道癌術後後縦隔再建胃管癌の2例
  • リンショウ ケイケン イカングチガワ オ ノコシテ ユウケイ クウチョウ サイケン オ オコナッタ ショクドウ ガン ジュツゴ ゴ ジュウカク サイケン イカンガン ノ 2レイ

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Abstract

We have experienced two successfully resected cases of metachronous gastric tube cancer after esophagectomy for thoracic esophageal cancer, when the primary feeding vessels were dissected. (Case 1) A 73-year-old man had undergone right trans-thoracic subtotal esophagectomy for esophageal cancer with gastric pull-up via a posterior mediastinum route. Two years and 4 months after the surgery, metachronous cancer was revealed in the reconstructed gastric tube. The gastric tube was severely adhered to adjacent organs, such as lung and bronchus in the upper mediastinum. Therefore, we resected at 2 cm distal to the gastric tube and reconstructed with pedicled jejunum via a posterior mediastinum route. (Case 2) A 50-year-old man had undergone right trans-thoracic subtotal esophagectomy for esophageal cancer with gastric pull-up via a posterior mediastinum route. Five years and 6 months later, metachronous Type 3 cancer was detected in the reconstructed gastric tube. The gastric tube was severely adhered to adjacent organs, such as bronchus and right recurrent nerve in the upper mediastinum. Therefore, we resected at several cm distal to the gastric tube and reconstructed with pedicled jejunum via a posterior mediastinum route. In both patients, the remnant gastric tube stump showed no ischemic change, with a successful outcome.

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