Pylorus Preserving Subtotal Esophagogastrectomy with Replacement of Right Hemicolon Treated in a Case of Synchronous Double Cancers of the Esophagus and Stomach

Tomoaki Yano, Katsunori Nakatani, Akihiko Watanabe, Hidetomo Sawada, Yukishige Yamada, Yoshihide Shino, Naoto Ueyama, Masahiro Tanase, Takashi Yamada, Hiroshige Nakano

First Department of Surgery, Nara Medical University

We report a case of synchronous double cancers of the esophagus and stomach treated by pylorus preserving subtotal esophagogastrectomy with replacement of the right hemicolon. A 60-year-old man was admitted complaining of epigastralgia. Upper gastrointestinal series and endoscopy revealed synchronous double cancers of the esophagus (ulcerative and localized type carcinoma of the middle third of the esophagus) and stomach (Borrmann type 2 carcinoma of the anterior wall of the lower part of the gastric body; Borrmann type 3 carcinoma of the posterior wall of the lower part of the gastric body). Subtotal esophagectomy was performed, and subtotal gastrectomy was performed at a resection line 1.5 cm from the pyloric ring. Reconstruction was made by using the right hemicolon, and cervical esophago-ileostomy and colo-residual gastrostomy with end-to-end anastomoses were performed. We consider that this operation has the following merits: it increases the capacity of the substitute stomach and prevents Damping's syndrome by preserving the pylorus, and is a physiological reconstruction that can provide good secretion of gastrointestinal hormone.

Key words
synchronous double cancers of the esophagus and stomach, pylorus preserving subtotal esophagogastrectomy

Reprint requests
Tomoaki Yano First Department of Surgery, Nara Medical University
840 Shijocho, Kashihara, 634 JAPAN

Accepted
July 7, 1993

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