Esophageal and Gastroenterological Surgery, Juntendo University Hospital, Tokyo, Japan
Esophageal and Gastroenterological Surgery, Juntendo University Hospital, Tokyo, Japan.
BMJ Case Rep. 2024 Sep 13;17(9):e260692. doi: 10.1136/bcr-2024-260692.
Intrathoracic herniation of the gastric tube pulled up through the retrosternal route after oesophagectomy is relatively rare and usually can be managed by conservative treatment.We present two patients who needed reoperation for intrathoracic herniation of gastric tube after minimally invasive oesophagectomy for thoracic oesophageal cancer. Postoperatively, both patients showed herniation and acute twist of the gastric tube. Due to the twist of the gastric tube, one patient had ischaemic change of the proximal tip of the gastric tube, and the other patient showed delayed gastric emptying, both of which led to surgical repairs. In this case report, we discuss why the herniation of gastric tube from the retrosternal route occurs, how to decide to do reoperation and how to prevent this complication.
胸内胃管经胸骨后路径拔出后疝出相对少见，通常可通过保守治疗进行处理。我们报告了 2 例微创胸段食管癌切除术后因胸内胃管疝出而行再次手术的患者。术后，2 例患者均出现胃管疝出和急性扭转。由于胃管扭转，1 例患者的胃管近端出现缺血性改变，另 1 例患者出现胃排空延迟，均需行手术修复。在本病例报告中，我们讨论了胸骨后路径胃管疝出的原因、决定再次手术的因素以及如何预防该并发症。
