1995 Volume 56 Issue 12 Pages 2628-2632
We experienced two rare cases of stomal recurrence after total gastrectomy for gastric cancer which were successfully resected by left thoraco-abdominal approach.
Patient 1 was admitted to the hospital because of dysphagia 4 years and 4 months after the total gastrectomy for a gastric cancer, when no macroscopic and microscopic cancer cells were found at the oral surgical margin of the resected stomach. Re-operation (lower esophago-jejunostomy) was performed under a diagnosis of stomal recurrence. He was well after the second surgery, but died of pleural dissemination and neck bone metastasis 7 years after the first surgery in spite of chemotherapy and radiotherapy.
Patient 2 was admitted to the hospital because of dysphagia one year and 8 months after total gastrectomy for a gastric cancer, when cancer cells were macroscopically negative but microscopically positive at the oral surgical margin of the resected stomach. The patient received radiotherapy after the first operation. Re-operation (lower esophago-jejunostomy) was performed under a diagnosis of stomal recurrence. He remains well for 5 years and 7 months after the second surgery.
These results suggest that reoperation is recommended to stomal recurrence after total gastrectomy, if the patient has no other organ metastasis and the reoperation is expected to contribute to the improvement of the quality of life of the patient.
