RESECTION OF CANCER IN THE GASTRIC TUBE USED IN RECONSTRUCTION AFTER RADICAL SURGERY FOR ESOPHAGEAL CANCER-REPORT OF FIVE CASES-

Abstract

During the recent three decades from 1966 to 1995, we treated 5 patients with gastric tube cancer after a radical esophagectomy for an esophageal cancer. These patients were subjected to a study of age, location of cancer, operative procedure, pathological findings, route of reconstruction at esophagectomy, as well as endoscopic findings, prognosis and the same factors mentioned above at surgery for gastric tube cancer. Mean age was 62 years (range: 57 to 68 at esophagectomy). All cases had undergone an transthoracic esophagectomy. Three cases were reconstructed via retrosternal route, and two cases via posterior mediastinal route at the time of esophagectomy. On the other hand, at the time of operation for gastric tube cancer, a mean age was 68.4 years (range: 63 to 71). Four cancers were located in the antrum, and three cases were performed surgical local resection (SLR). Three cases keep no evidence of disease, but one was dead due to exacerbation of the disease and one died of pneumonia after surgery for the gastric tube cancer. We suggest that SLR is useful technique for early cases, because of difficulty in radical resection for gastric tube cancer. It is important to go through endoscopic examination more than once a year regularly after surgery to detect the disease in an early stage.