title: [A case of stenosis of the reconstructed jejunum due to recurrent cancer after total gastrectomy in which stent-in-stent placement was effective].
abstract: OBJECTIVE
  We report one case of stenosis of the reconstructed jejunum due to recurrent cancer after total gastrectomy in which stenting was effective and good QOL was achieved.
  
  
  METHODS
  The patient was a 70-year-old woman. In July 2000, the patient underwent total gastrectomy.Roux-en Y reconstruction with a diagnosis of gastric cancer. The pathological diagnosis was U-Post, Type 3, por 1, T3, N1, H0, P0, CY0, M0, and Stage IIIA. From 9 months after the operation, aphagia occurred and stenosis of the reconstructed jejunum was noted. Based on a biopsy of the stenosis, a diagnosis of post-operative recurrent gastric cancer was made. Although the patient received two cycles of low-dose FP therapy, complete response was not obtained, and the patient stayed at home under the IVH control for about 4 months. In June 2001, the patient was hospitalized for a stent placement due to the patient's request.
  
  
  METHODS
  After a guide wire was endoscopically inserted and a good passage on the anal side of the stenosis was confirmed, a stent was placed. Self Expandable Metallic Stent (SEMS) was used.
  
  
  METHODS
  Following the stent placement, the patient was able to ingest orally, but 6.5 months later, stenotic symptoms developed and another stent was deployed (stent in stent).
  
  
  CONCLUSIONS
  Stenting is relatively simple and less invasive, which is useful for the improvement of QOL and in recurrent cases as well.
authors.affiliation: Third Dept. of Surgery, Tokyo Medical University.
authors.forename: Yoshihiro
authors.initials: Y
authors.lastname: Ota
authors.forename: Yu
authors.initials: Y
authors.lastname: Takagi
authors.forename: Yoshiaki
authors.initials: Y
authors.lastname: Osaka
authors.forename: Sumito
authors.initials: S
authors.lastname: Hoshino
authors.forename: Motoo
authors.initials: M
authors.lastname: Shinohara
authors.forename: Hideo
authors.initials: H
authors.lastname: Sudo
authors.forename: Akihiko
authors.initials: A
authors.lastname: Tsuchida
authors.forename: Tatsuya
authors.initials: T
authors.lastname: Aoki
mesh_terms: D000368:Aged; D003251:Constriction, Pathologic / Q000000981:diagnostic imaging / Q000473:pathology* / Q000601:surgery*; D004384:Duodenoscopy; D005260:Female; D005743:Gastrectomy; D006801:Humans; D007580:Jejunal Neoplasms / Q000000981:diagnostic imaging / Q000556:secondary* / Q000601:surgery*; D019651:Plastic Surgery Procedures; D012008:Recurrence; D015607:Stents; D013274:Stomach Neoplasms / Q000000981:diagnostic imaging / Q000601:surgery*; D014057:Tomography, X-Ray Computed