title: Two-stage operation for synchronous triple primary cancer of the esophagus, stomach, and ampulla of Vater: report of a case.
abstract: A 69-year-old man with jaundice was diagnosed with cancer of the ampulla of Vater by endoscopic retrograde cholangiopancreatography and abdominal computed tomography. A screening gastrointestinal endoscopy showed middle thoracic esophageal cancer and early gastric cancer on the anterior wall of the lower gastric body. We chose a two-stage operation for synchronous triple primary cancer of the esophagus, stomach, and ampulla of Vater, in order to safely perform the curative resection of these three cancers. The first-stage operation consisted of a right transthoracic subtotal esophagectomy with mediastinal and cervical lymph node dissection, an external esophagostomy in the neck, and a gastrostomy. Thirty-five days after the first surgery, a total gastrectomy with regional lymph node dissection, and a pancreatoduodenectomy with Child's reconstruction were performed as the second-stage surgery. Esophageal reconstruction was achieved using the ileocolon via the percutaneous route without vascular anastomosis.
authors.affiliation: Division of Surgical Oncology, Department of Surgery, Nagoya University Graduate School of Medicine, 65 Tsurumai-cho, Showa-ku, Nagoya, 466-8550, Japan, mafukaya@med.nagoya-u.ac.jp.
authors.forename: Masahide
authors.initials: M
authors.lastname: Fukaya
authors.forename: Tetsuya
authors.initials: T
authors.lastname: Abe
authors.forename: Yukihiro
authors.initials: Y
authors.lastname: Yokoyama
authors.forename: Keita
authors.initials: K
authors.lastname: Itatsu
authors.forename: Masato
authors.initials: M
authors.lastname: Nagino
mesh_terms: D000230:Adenocarcinoma / Q000175:diagnosis / Q000601:surgery*; D000368:Aged; D014670:Ampulla of Vater; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D002166:Camptothecin / Q000008:administration & dosage / Q000031:analogs & derivatives; D018288:Carcinoma, Small Cell / Q000175:diagnosis / Q000601:surgery*; D002294:Carcinoma, Squamous Cell / Q000175:diagnosis / Q000601:surgery*; D002945:Cisplatin / Q000008:administration & dosage; D003131:Combined Modality Therapy; D003138:Common Bile Duct Neoplasms / Q000175:diagnosis / Q000601:surgery*; D003952:Diagnostic Imaging; D013505:Digestive System Surgical Procedures / Q000379:methods*; D004938:Esophageal Neoplasms / Q000175:diagnosis / Q000601:surgery*; D017809:Fatal Outcome; D006801:Humans; D000077146:Irinotecan; D008197:Lymph Node Excision; D008297:Male; D009378:Neoplasms, Multiple Primary / Q000175:diagnosis / Q000601:surgery*; D011471:Prostatic Neoplasms; D019651:Plastic Surgery Procedures / Q000379:methods; D013274:Stomach Neoplasms / Q000175:diagnosis / Q000601:surgery*
chemical_list: D000077146:Irinotecan; D002945:Cisplatin; D002166:Camptothecin