Abstract
Succesful surgical outcome has been obtained for a carcinoma arising in the substituted gastric tube after radical operation for an esophageal cancer, in which the section of the natural feeding arteries, namely, right gastric and right gastroepiploic arteries, which partial resection of the gastric tube was carried out.
A 75-year-old man was admitted to the hospital because of a subcutaneous mass in the forechest. About 5 years before, the patient underwent curative subtotal esophagectomy with reconstruction by antesternal gastric tube substitution for an esophageal cancer. The subcutaneous mass was diagnosed as cancer of the gastric tube by biopsy. For an advanced age of the patient, a safe and still curative resurgery was intended. First, the two feeding arteries, right gastric and right gastroepiploic, nurishing the gastric tube were clamped for 20 minutes to insure that the blood supply to the substituted stomach was not jeopardized. Then, the two vesseles were sectioned and lymph nodes dissection was performed. The tumor-bearing gastric tube was resected with a 2 cm proximal and a 3 cm distal clearace followed by a reconstruction with a Roux-en-Y gastrojejunostomy. The patient has been well for more than 3 years.
This surgical procedure may be recommended for aged patients or those with poor general conditions whom it will promise the therapeutic effects.
