title: [Local resection and less-invasive re-reconstruction by reuse of the Roux-en-Y limb in a patient with lower esophageal cancer previously treated with total gastrectomy with Roux-en-Y anastomosis].
abstract: A 79-year-old-woman underwent distal gastrectomy for the treatment of gastric cancer 17 years previously and total gastrectomy with Roux-en-Y reconstruction for the treatment of remnant gastric cancer 14 years previously. She was followed up at our outpatient clinic periodically after the gastric surgery. She reported an abnormal feeling in her upper abdomen, and therefore, an abdomen examination was planned. Upper gastrointestinal endoscopy showed a type II tumor extending over the esophagojejunal anastomosis. Biopsy revealed malignant findings, but the histological type could not be determined. Computed tomography revealed neither lymph node nor distant organ metastasis. Because the patient was of advanced age and had chronic obstructive pulmonary disease, we considered avoiding invasive surgeries, such as subtotal esophagectomy and reconstruction using colon tissue. Instead, we performed local resection and re-reconstruction via Roux-en-Y anastomosis by reusing the Roux-en-Y limb. More than 6 years after this surgery, the patient has not developed any signs of recurrence. Our method is less invasive and more effective than the usual surgical treatments for esophageal cancer in the lower esophagus after total gastrectomy.
authors.affiliation: Dept. of Surgery, Fujisaki Hospital.
authors.forename: Shuhei
authors.initials: S
authors.lastname: Suzuki
authors.forename: Shigeru
authors.initials: S
authors.lastname: Fujisaki
authors.forename: Motoi
authors.initials: M
authors.lastname: Takashina
authors.forename: Kenichi
authors.initials: K
authors.lastname: Sakurai
authors.forename: Ryouichi
authors.initials: R
authors.lastname: Tomita
authors.forename: Tadatoshi
authors.initials: T
authors.lastname: Takayama
mesh_terms: D000368:Aged; D000713:Anastomosis, Roux-en-Y; D001706:Biopsy; D004938:Esophageal Neoplasms / Q000601:surgery*; D005260:Female; D005743:Gastrectomy; D005763:Gastroenterostomy / Q000379:methods*; D006801:Humans; D009364:Neoplasm Recurrence, Local / Q000601:surgery