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Esophageal reconstruction with remnant stomach: A case report and review of literature

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Author(s): Song-Ping Xie | Guo-Hua Fan | Gan-Jun Kang | Qing Geng | Jie Huang | Bang-Chang Cheng

Journal: World Journal of Gastroenterology
ISSN 1007-9327

Volume: 19;
Issue: 20;
Start page: 3169;
Date: 2013;
Original page

Keywords: Gastric remnant | Distal | Gastrectomy | Esophageal cancer | Substitution

ABSTRACT
The number of patients developing esophageal cancer after gastrectomy has increased. However, gastric remnant is very rarely used for reconstruction in esophageal cancer surgery because of the risk of anastomotic leakage resulting from insufficient blood flow. We present a case of esophageal cancer using gastric remnant for esophageal substitution after distal gastrectomy in a 57-year-old man who presented with a 1-month history of mild dysphagia and a background history of alcohol abuse. Gastroscopy showed a 1.2 cm × 1.0 cm bulge tumor of the lower third esophagus with the upper margin located 39 cm from the dental arcade. Computed tomography of the chest showed lower third esophageal wall thickening. The patient underwent en bloc radical esophagectomy with a two-field lymph node dissection of the upper abdomen and mediastinum via a left-sided posterolateral thoracotomy through the seventh intercostal space. The upper end of the esophagus was resected 5 cm above the tumor. The gastric remnant was used for reconstruction of the esophago-gastrostomy and placed in the left thoracic cavity. The patient started a liquid diet on postoperative day 8 and was discharged on the 10th postoperative day without complications. In this report, we demonstrate that the gastric remnant may be used for reconstruction in patients with esophageal cancer as a substitute organ after distal gastrectomy.

Tango Jona
Tangokurs Rapperswil-Jona

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