Clinical characteristics and management of gastric tube cancer after esophagectomy

Shirakawa, Yasuhiro; Noma, Kazuhiro; Maeda, Nobuyo; Ninomiya, Takayuki; Tanabe, Satoshi; Kikuchi, Shinichi; Kuroda, Shigetoshi; Nishizaki, Masahiko; Kagawa, Shunsuke; Kawahara, Yoshiro; Okada, Hiroyuki; Fujiwara, Toshiyoshi

doi:10.1007/s10388-018-0611-2

Cited by 22 publications

(27 citation statements)

References 21 publications

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“…In our case, we diagnosed the tumor as an advanced cancer, so we decided to perform surgical resection. Gastric tube cancer mostly occurs in the distal region of the gastric tube [12], and the tumor was located near the pyloric ring in our case. Regarding curability, it has been reported that total gastrectomy is necessary for upper gastric tube cancer, but that resection of the distal gastric tube would be sufficient for lower gastric tube cancer [13].…”

Section: Discussionmentioning

confidence: 55%

Successful preservation of the proximal stomach tube by evaluating blood flow using indocyanine green for gastric tube cancer: a case report

et al. 2020

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Background: There have been two reports on preserving the proximal gastric tube by using intraoperative indocyanine green (ICG)-based photodynamic detection to evaluate blood flow through the anastomosis for gastric tube cancer after esophagectomy. However, in those cases, the period since the first operation was > 3 years 11 months, and there have been no reports of cases with < 1-year periods after the first operation. Case presentation: A 59-year-old man underwent video-assisted thoracic subtotal esophagectomy and gastric tube reconstruction after two courses of preoperative chemotherapy for middle thoracic esophageal cancer. After half a year, follow-up upper gastrointestinal endoscopy showed a submucosal tumor in the posterior wall of the pre-pyloric region. We performed a biopsy, and the results led to a diagnosis of gastric cancer (moderately differentiated adenocarcinoma: tub2). Clinically, the patient was described as having stage IB (cT2N0M0) gastric cancer of the reconstructed gastric tube. To avoid total gastrectomy, we tried to evaluate the blood flow of the proximal part of the gastric tube by intraoperative ICG-based photodynamic detection. Intraoperative findings confirmed neo-vascularization from the remnant cervical esophagus to the upper region of the gastric tube approximately 7 cm through the esophagogastric anastomosis. Therefore, we dissected the distal part of the gastric tube approximately 4 cm from the esophagogastric anastomosis and then performed Roux-en-Y gastro-jejunostomy via the ante-sternum route. The postoperative course was stable, and the patient was discharged on the 14th postoperative day. Conclusions: ICG-based photodynamic diagnosis was found to be simple and less invasive. Therefore, even if the postoperative period is short, this method should be considered for evaluation of blood flow prior to performing less invasive surgery.

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Section: Discussionmentioning

confidence: 55%

Successful preservation of the proximal stomach tube by evaluating blood flow using indocyanine green for gastric tube cancer: a case report

et al. 2020

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“…Our patient developed the metachronous gastric malignancy relatively early, at about 26 months after the first surgery. Given the wide range of onset of metachronous GTCs, the importance of the annual endoscopic surveillance cannot be overstated, as it allows early detection of potentially curable gastric tube cancers [2,3,6,11].…”

Section: Discussionmentioning

confidence: 99%

“…Although the etiology remains uncertain, factors presumably involved in the carcinogenesis are the mediastinal radiotherapy, reflux-induced intestinal metaplasia in vagotomized gastric tubes or Helicobacter pylori [6,13,14]. The choice of therapy should be tailored to the patient and tumor stage.…”

Section: Discussionmentioning

confidence: 99%

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Metachronous Gastric Tube Cancer After Esophagectomy with Gastric Pull-Up – Case Report

Jorge¹,

Müller²,

Gafarli³

et al. 2020

SCR

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The progresses in the therapy and methods of diagnosis of malignancies led to a prolonged survival and, consequently, to an increase in secondary tumors in cancer survivor patients [1-7]. We report the case of a 64-year-old patient who was diagnosed with a second primary adenocarcinoma in the gastric conduit, more than two years after the esophagectomy with gastric pull-up. We performed a resection of the gastric conduit and reconstructed with an ileocolon interposition.

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“…Moreover, preservation of the main trunk of the right gastroepiploic artery (RGEA) and the right gastric artery (RGA) would retain the main blood supply to the reconstructed gastric tube, given that the other gastric vessels were divided during the previous surgery. Several reports have described successful partial resection for early GTC[ 6 , 7 ]. Here, we present a successful case of surgical treatment for GTC and provide details of the surgical procedure.…”

Section: Introductionmentioning

confidence: 99%

Distal gastric tube resection with vascular preservation for gastric tube cancer: A case report and review of literature

Yura

Koyanagi

Adachi

et al. 2020

WJGS

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BACKGROUND Survival rates in patients with esophageal cancer undergoing esophagectomy have improved, but the prevalence of gastric tube cancer (GTC) has also increased. Total resection of the gastric tube with lymph node dissection is considered a radical treatment, but GTC surgery is more invasive and involves a higher risk of severe complications or death, particularly in elderly patients. CASE SUMMARY We report an elderly patient with early GTC that had invaded the duodenum who was successfully treated with resection of the distal gastric tube and Roux-en-Y (R-Y) reconstruction. The tumor was a type 0-IIc lesion with ulcer scars surrounding the pyloric ring. Endoscopic submucosal resection was not indicated because the primary lesion was submucosally invasive, was undifferentiated type, surrounded the pyloric ring, and had invaded the duodenum. Resection of distal gastric tube with R-Y reconstruction was safely performed, with preservation of the right gastroepiploic artery (RGEA) and right gastric artery (RGA). CONCLUSION Distal resection of the gastric tube with preservation of the RGEA and RGA is a good treatment option for elderly patients with cT1bN0 GTC in the lower part of the gastric tube.

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Clinical characteristics and management of gastric tube cancer after esophagectomy

Abstract: GTCs may occur late in the postoperative course following TEC surgery. If they are discovered at an early stage, these lesions can be cured with ESD. Long-term periodic endoscopic examinations after TEC surgery are important.

Cited by 22 publications

References 21 publications

Successful preservation of the proximal stomach tube by evaluating blood flow using indocyanine green for gastric tube cancer: a case report

Successful preservation of the proximal stomach tube by evaluating blood flow using indocyanine green for gastric tube cancer: a case report

Metachronous Gastric Tube Cancer After Esophagectomy with Gastric Pull-Up – Case Report

Distal gastric tube resection with vascular preservation for gastric tube cancer: A case report and review of literature

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