Three Cases of Cancer in the Reconstructed Gastric Tube after Radical Resection for Esophageal Cancer, Resected by Different Surgical Procedure

Shinya Hamasu, Naoki Yokoo, Yasuhito Kitakado, Takahito Adachi, Takahiro Yoshida, Katsuaki Ura, Yoshihiro Tanaka, Hiromitsu Nagata and Kiyohisa Okamoto^*

Department of Surgery, Department of Pathology^*, Takayama Red Cross Hospital

We report 3 resected cases of cancer in the reconstructed gastric tube after radical resection for esophageal cancer. Case 1. A 68-year-old man undergoing subtotal esophagectomy reconstructed by stomach tube via a retrosternal route in 1994 was found 2 years later to have type I early gastric cancer at the gastric tube and underwent endoscopic mucosal resection (EMR) 3 times. He died of a pulmonary embolism 3 years and 7 months after the second operation. Case 2. A 55-year-old man undergoing subtotal esophagectomy with reconstruction by stomach tube via a retrosternal route in 1993 underwent local resection for type IIc+III early gastric tube cancer 7 years later. The patient remains alive and recurrence-free 1 year and 10 months after reoperation. Case 3. A 76-year-old man undergoing total esophagectomy reconstructed by stomach tube via a retrosternal route in 1989 was diagnosed with type 3 advanced cancer at the reconstructed stomach tube 12 years after the earlier operation. He underwent subtotal tube resection but died of local recurrence 1 year and 2 months later. The prognosis of cancer in the gastric tube is generally poor, but many survivors have been reported thanks to early diagnosis. Regular endoscopy is necessary to detect the disease early after esophageal surgery.

Key words
esophageal cancer, cancer in reconstructed gastric tube

Reprint requests
Shinya Hamasu Department of Surgery, Takayama Red Cross Hospital 3-11 Tenman-cho, Takayama, 506-8550 JAPAN

Accepted
November 27, 2002

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