A Case of Gastric Cancer with Gastric Outlet Obstruction Successfully Treated by Multimodal Therapy Under W‐ED® Tube Placement

DOI Web Site 3 References
  • Hirakawa Yuta
    Department of Surgery, Social Medical Corporation SEIIKAI Southern Region Hospital
  • Mizoguchi Tadao
    Department of Surgery, Social Medical Corporation SEIIKAI Southern Region Hospital
  • Shirao Sadaki
    Department of Surgery, Social Medical Corporation SEIIKAI Southern Region Hospital
  • Omoto Itaru
    Department of Surgery, Social Medical Corporation SEIIKAI Southern Region Hospital
  • Makisumi Kanro
    Department of Surgery, Social Medical Corporation SEIIKAI Southern Region Hospital
  • Okumura Hiroshi
    Department of Surgery, Social Medical Corporation SEIIKAI Southern Region Hospital

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Other Title
  • W‐ED<sup>®</sup>チューブを用いた在宅栄養管理および外来化学療法後に胃切除を施行した幽門狭窄を伴う胃癌の1例

Abstract

<p> A 67‐year‐old man with upper abdominal pain and weight loss was diagnosed as having 3/4 circumferential mass of advanced gastric cancer extending to gastric lesser curvature （cT4aN1M0 stage IIIA）. After confirming the absence of peritoneal dissemination by laparoscopy, neoadjuvant chemotherapy （SOX） was started to reduce the size of the gastric cancer. After one course, the patient vomited and was judged to have clinically advanced, unresectable gastric cancer. His regimen was changed to CapeOX ＋ T‐mab. In addition, a W‐ED® tube, which has a double‐tube structure and can perform gastric decompression and enteral nutrition, was placed. Enteral feeding could be performed without vomiting. The patient was discharged from the hospital after completion of one course, and after home nutritional management and two courses of outpatient chemotherapy, he underwent gastrectomy and was discharged from the hospital without any postoperative complications. The pathological diagnosis was ypT4aN0M0 stage IIb. He received adjuvant chemotherapy （S‐1） and was alive at 1 year and 3 months without recurrent disease. The maintenance and improvement of nutritional factors during the course of multidisciplinary treatment was considered to be extremely important for the performance of surgery.</p>

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