2018 Volume 32 Issue 2 Pages 198-202
A 67-year-old man was referred to our hospital for further evaluation and treatment after hospitalization for pneumothorax and left empyema in another hospital. Examinations revealed a gastric lymphoma presenting with a gastropleural fistula. He underwent surgery through a left thoracoabdominal incision. A large amount of pus had accumulated in the pleural cavity and the visceral pleura was significantly thickened. The tumor was located in the gastric fundus and invaded the diaphragm, spleen, and pancreas. We performed a total gastrectomy, splenectomy, distal pancreatectomy, decortications, and diaphragmatic reconstruction with a latissimus dorsi flap. Although the patient developed a pancreatic fistula, he was discharged 60 days after the surgery. With the excellent exposure it provides for thoracoabdominal surgery, enabling diaphragmatic reconstruction using the same incision, the left thoracoabdominal incision was an ideal approach for this case.
