Kanda T, Sato Y, Yajima K, Kosugi SI, Matsuki A, Ishikawa T, Bamba T, Umezu H, Suzuki T, Hatakeyama K. Pedunculated gastric tube interposition in an esophageal cancer patient with prepyloric adenocarcinoma. World J Gastrointest Oncol 2011; 3(5): 75-78 [PMID: 21603033 DOI: 10.4251/wjgo.v3.i5.75]
Corresponding Author of This Article
Tatsuo Kanda, MD, PhD, Division of Digestive and General Surgery, Niigata University Graduate School of Medical and Dental Sciences, 1-757 Asahimachi-dori, Niigata City 951-8510, Japan. kandat@med.niigata-u.ac.jp
Article-Type of This Article
Case Report
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Tatsuo Kanda, Yu Sato, Kazuhito Yajima, Shin-ichi Kosugi, Atsushi Matsuki, Takashi Ishikawa, Takeo Bamba, Katsuyoshi Hatakeyama, Division of Digestive and General Surgery, Niigata University Graduate School of Medical and Dental Sciences, 1-757 Asahimachi-dori, Niigata City 951-8510, Japan
Hajime Umezu, Division of Cellular and Molecular Pathology, Niigata University Graduate School of Medical and Dental Sciences, 1-757 Asahimachi-dori, Niigata City 951-8510, Japan
Tsutomu Suzuki, Department of Nursing, School of Health Science, Niigata University, 2-746 Asahimachi-dori, Niigata City 951-8518, Japan
Author contributions: Kanda T, Yajima K, Kosugi S and Ishikawa T performed surgery in this case; Kanda T, Kosugi S and Suzuki T designed the research; Kanda T, Sato S, Yajima K and Matsuki A drafted the manuscript; Bamba T and Umezu H were responsible for the pathological examinations; Suzuki T and Hatakeyama K revised the implementation of this work and reviewed the manuscript.
Correspondence to: Tatsuo Kanda, MD, PhD, Division of Digestive and General Surgery, Niigata University Graduate School of Medical and Dental Sciences, 1-757 Asahimachi-dori, Niigata City 951-8510, Japan. kandat@med.niigata-u.ac.jp
Telephone: +81-25-2272228 Fax: +81-25-2270779
Received: November 13, 2010 Revised: April 26, 2011 Accepted: May 3, 2011 Published online: May 15, 2011
Abstract
Gastric carcinoma is one of the malignancies that are most frequently associated with esophageal carcinoma. We describe herein our device for advanced esophageal cancer associated with early gastric cancer in the antrum. A 57-year-old man presenting with dysphagia and upper abdominal pain was admitted to our hospital. Preoperative examinations revealed locally advanced squamous cell carcinoma (SCC) of the middle thoracic esophagus (T3N0M0 Stage IIA) and mucosal signet-ring cell carcinoma of the gastric antrum (T1N0M0 Stage IA). Although the gastric tumor appeared to be an intramucosal carcinoma, its margin was obscure, so endoscopic en-bloc resection was considered inadequate. We chose surgical resection of the gastric tumor as well as the esophageal SCC after neoadjuvant chemotherapy with 5-fluorouracil and cisplatin for advanced esophageal cancer. Following transthoracic esophagectomy with three-field lymph node dissection, the gastric carcinoma was removed by gastric antrectomy, which preserved the right gastroepiploic vessels, and a pedunculated short gastric tube was used as the esophageal substitute. Twenty-eight months after the surgery, the patient is well with no evidence of cancer recurrence. Because it minimizes surgical stress and organ sacrifice, gastric tube interposition is a potentially useful technique for esophageal cancer associated with localized early gastric cancer.
