A case of delayed gastric conduit emptying after subtotal esophagectomy with simultaneous pulmonary resection

Abstract

We report a case of delayed gastric conduit emptying (DGCE) after surgery for esophageal cancer. A 67-year-old man who visited a hospital because of dysphagia and was referred for a diagnosis of esophageal cancer. Contrast-enhanced computed tomography (CT) showed wall thickening of the middle thoracic esophagus and an enlarged abdominal lymph nodes and a spiculated pulmonary shadow 25×20 mm in size in right lower lobe that was highly suspected as a primary lung cancer. Preoperative chemotherapy was introduced due to advanced esophageal cancer, both the esophageal tumor and the pulmonary lesion were found to be shrunk. Even after a detailed examination, the shadow in the right lower lobe of the lung could not be ruled out for malignancy, a simultaneous surgery was conducted. The patient underwent S10 segmentectomy followed by subtotal esophagectomy and the posterior mediastinal route reconstruction using a gastric conduit. Gastrografin radiography revealed stasis of the reconstructed gastric conduit on postoperative day (POD) 8. CT and upper gastrointestinal endoscopy showed that the gastric conduit was pulled into the right thoracic cavity caused by pulmonary resection and developed inflammatory changes, causing DGCE. The DGCE eventually improved with conservative treatment and the patient was discharged on POD 68. J. Med. Invest. 72 : 189-193, February, 2025