title: Adenocarcinoma in long-segment Barrett's esophagus 44 years after total gastrectomy.
abstract: Although Barrett's esophagus may occur without gastric acid, Barrett's adenocarcinoma after total gastrectomy is rare. Here, we present Barrett's adenocarcinoma in long-segment Barrett's esophagus after total gastrectomy. The patient was a 74-year-old male who underwent total gastrectomy 44 years ago. An endoscopic examination revealed long-segment Barrett's esophagus starting 17 cm from the incisors and continuing 20 cm to esophagojejunostomy, with irregular mucosa 27-31 cm from the incisors. Pathological diagnosis of a biopsied specimen was adenocarcinoma. We performed subtotal esophagectomy with lymph node dissection in the prone position and reconstructed the esophagus with ileocolic interposition. Postoperative pathological diagnosis from a Barrett's epithelial section was well differentiated adenocarcinoma. This case had the longest interval from total gastrectomy and smallest oral margin of Barrett's epithelium. Our case suggested that careful surveillance is needed for patients exhibiting recurrent bile reflux following total gastrectomy.
authors: Department of Surgery and Science, Graduate School of Medicine and Pharmaceutical Sciences for Research, University of Toyama, Sugitani 2630, Toyama, Japan Department of Nanobaio Drug Discovery, Graduate school of Pharmaceutical Sciences, Kyoto University. Yoshida Shimoadachi-cho, 46-29, Sakyo-ku, Kyoto, Japan.
authors: Yutaka
authors: Y
authors: Shimada
authors: Department of Surgery and Science, Graduate School of Medicine and Pharmaceutical Sciences for Research, University of Toyama, Sugitani 2630, Toyama, Japan.
authors: Tomoyuki
authors: T
authors: Okumura
authors: Department of Surgery and Science, Graduate School of Medicine and Pharmaceutical Sciences for Research, University of Toyama, Sugitani 2630, Toyama, Japan.
authors: Shozo
authors: S
authors: Hojo
authors: Department of Surgery and Science, Graduate School of Medicine and Pharmaceutical Sciences for Research, University of Toyama, Sugitani 2630, Toyama, Japan.
authors: Koshi
authors: K
authors: Matsui
authors: Department of Surgery and Science, Graduate School of Medicine and Pharmaceutical Sciences for Research, University of Toyama, Sugitani 2630, Toyama, Japan.
authors: Takuya
authors: T
authors: Nagata
authors: Department of Pathology, Graduate School of Medicine and Pharmaceutical Sciences for Research, University of Toyama, Sugitani 2630, Toyama, Japan.
authors: Shinichi
authors: S
authors: Hayashi
authors: Department of Surgery, Itoigawa Hospital, Takegahana 457-1, Itoigawa, Niigata, Japan.
authors: Kenichi
authors: K
authors: Tazawa
authors: Department of Surgery, Itoigawa Hospital, Takegahana 457-1, Itoigawa, Niigata, Japan.
authors: Fuminori
authors: F
authors: Yamagishi
authors: Department of Surgery and Science, Graduate School of Medicine and Pharmaceutical Sciences for Research, University of Toyama, Sugitani 2630, Toyama, Japan.
authors: Kazuhiro
authors: K
authors: Tsukada