title: Ivor-Lewis esophagectomy for esophageal cancer after distal gastrectomy.
abstract: We report the use of gastric remnant for esophageal substitution after distal gastrectomy in a 53-year-old man with esophageal cancer. This patient had a 4-month history of progressive dysphagia for solid food. An upper gastrointestinal endoscopy showed a 7.0 cm bulge tumor in the middle-lower esophagus, wherein the upper margin was located 28 cm from the dental arcade. Computed tomography (CT) of the chest revealed wall thickening in the middle-lower esophagus. In this case, radical en bloc esophagectomy with a two-field lymph node dissection was performed in the upper abdomen and mediastinum via a posterolateral right thoracotomy through the fifth intercostal space. Esophagogastric anastomosis was performed mechanically in the apex of the chest using a circular stapler. The gastric remnant was used for reconstruction of the esophago-gastrostomy and placed in the right thoracic cavity. The patient was discharged on the 12th postoperative day without complications. The gastric remnant may be used for reconstruction in patients with esophageal cancer as a substitute organ after distal gastrectomy.
authors.affiliation: Department of Thoracic Surgery, Renmin Hospital of Wuhan University, Wuhan 430060, China.
authors.forename: Song-Ping
authors.initials: SP
authors.lastname: Xie
authors.affiliation: Department of Thoracic Surgery, Renmin Hospital of Wuhan University, Wuhan 430060, China.
authors.forename: Gan-Jun
authors.initials: GJ
authors.lastname: Kang
authors.affiliation: Department of Thoracic Surgery, Renmin Hospital of Wuhan University, Wuhan 430060, China.
authors.forename: Guo-Hua
authors.initials: GH
authors.lastname: Fan
authors.affiliation: Department of Thoracic Surgery, Renmin Hospital of Wuhan University, Wuhan 430060, China.
authors.forename: Qing
authors.initials: Q
authors.lastname: Geng
authors.affiliation: Department of Thoracic Surgery, Renmin Hospital of Wuhan University, Wuhan 430060, China.
authors.forename: Jie
authors.initials: J
authors.lastname: Huang
keywords: Gastric remnant; distal; esophageal cancer; gastrectomy; substitution