A Case of Esophago-gastric Cancer with Reconstruction after Roux en Y with Microvascular Anastomosis to Internal Mammary Vessels -Supercharge-

Kunihiko Kaneda, Yoshio Ishikawa, Naoko Okuyama, Tetsuya Kuniyasu, Muneharu Konishi, Shirou Nakae, Takashi Kawamura, Yoshihiro Kanbara, Norio Kohno and Seishi Nakaya

Department of Surgery, Hyogo Medical Center for Adults

We experienced a case of advanced esophago-gastric double cancer with reconstruction after jejunal pull up after Roux en Y with microvascular anastomosis to inernal mammary vessels-supercharge-. A-58-year old man was diagnosed as both advanced esophageal cancer and gastric cancer. The operative procedure was consisted of subtotal esophagectomy and total gastrectomy, and reconstruction was performed jejunal pull up through anterior chest wall after Roux et Y anastomosis. To overcome vascular insufficiency of the pull-up jejunum, the authors have performed microvascular anastomosis between jejunal vessels and left internal mammary vessels. Subcutaneous dissection of the anterior chest wall and the second and third costal cartilages were resected at the left border of the sterunum, and a pedicle of internal thoracic artery and vein was dissected. End-to-end anastomosis of both the arteries and veins between jejunal vessels and left internal mammary vessels was performed. It is conceivable that the addition of supercharge to jejunal reconstruction for esophageal replacement is a good substitute for the thoracic esophagus, especially in cases where the stomach is unavailable for use.

Key words
esophageal cancer, microsurgery, supercharge

Reprint requests
Kunihiko Kaneda Department of Surgery, Hyogo Medical Center for Adults 13-70 Kitaoji-cho, Akashi, 673-8558 JAPAN

Accepted
November 30, 1999

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