Muto I, Yabusaki H, Takeda N, Katayanagi N, Aizawa K, Suzuki T, Tanaka O, Muto T, Soga J
1st Dept. of Surgery, College of Biomedical Technology Niigata Univ. School of Medicine.
Gan No Rinsho. 1990 Nov;36(14):2409-14.
Reported are five patients who developed a carcinoma of the reconstructed gastric tube. In 3 of the 5 patients, the esophageal cancer was preceded by a gastric cancer, and the intervals before the gastric cancer was detected were 34, 24, and 60 months. The gastric tube the had been reconstructed by the retrosternal rout was resected with a median sternotomy in cases 1 and 2. In case 3, since a liver and lung metastasis had been detected by routine examination, surgery was not performed. Cases 4 and 5 had an esophageal cancer associated with a simultaneous early gastric cancer located in the lesser curvature of the upper body. Thus, a esophagectomy and a partial gastrectomy were performed. Twenty-eight and 21 months later, respectively, an early gastric cancer was found at the stump of the gastric tube that had been reconstructed by the retrosternal route. Endoscopic laser therapy was subsequently employed for both patients. Because of these findings, the author have concluded that postoperative serial examination of the gastric tube are very important, since cases of a gastric tube cancer are increasing.
报告了5例重建胃管发生癌的患者。5例患者中有3例,食管癌之前存在胃癌,胃癌被发现前的间隔时间分别为34、24和60个月。病例1和2经胸骨正中切开术切除了经胸骨后途径重建的胃管。病例3因常规检查发现肝和肺转移而未进行手术。病例4和5患有食管癌,同时伴有位于上体小弯处的早期胃癌。因此,进行了食管切除术和部分胃切除术。分别在28个月和21个月后,在经胸骨后途径重建的胃管残端发现早期胃癌。随后对两名患者均采用了内镜激光治疗。基于这些发现,作者得出结论,由于胃管癌病例在增加,术后对胃管进行系列检查非常重要。