Abstract
A 66-year-old man presented with a history of black stools, heartburn, and difficulty swallowing. Anemia was detected. Detailed examinations revealed esophageal cancers in the middle thorax (Type 2) and lower thorax (Type 0-Ⅱc). The clinical stage was cT3N0M0 cStage Ⅱ. After two courses of 5-fluorouracil+cisplatin therapy, partial esophagectomy through a right thoracotomy, three-field lymphadenectomy, retrosternal gastric tube reconstruction, and enterostomy were performed. On postoperative day 7, anastomotic leakage occurred and the cervical wound was opened. Because no resolution was seen after two months, endoscopy was performed on postoperative day 74, revealing anastomotic site occlusion. Contrast-enhanced computed tomography did not depict approximately 3cm of the gastric tube at anal to the anastomotic site, indicating gastric tube ischemia. On postoperative day 106, median sternotomy and re-anastomosis of the esophagus and gastric tube were performed. Re-anastomosis was accomplished with resection of 1.0cm of the esophagus and 2.5cm of the gastric tube. The postoperative course was favorable.
We report our experience with a case undergoing re-anastomosis of the esophagus and gastric tube through a median sternotomy. This patient had an occluded gastric tube resulting from anastomotic leakage caused by gastric tube ischemia after esophageal cancer surgery.
