scholarly journals Thoracoscopic retrosternal gastric conduit resection in the supine position for gastric tube cancer

2019 ◽  
Vol 13 (3) ◽  
pp. 461-464 ◽  
Author(s):  
Kazumasa Horie ◽  
Taro Oshikiri ◽  
Yu Kitamura ◽  
Masaki Shimizu ◽  
Yuta Yamazaki ◽  
...  
Keyword(s):  
Supine Position ◽  
Gastric Tube ◽  
Gastric Conduit ◽  
Gastric Tube Cancer

scholarly journals 322 THORACOSCOPIC RETROSTERNAL GASTRIC CONDUIT RESECTION IN THE SUPINE POSITION FOR GASTRIC TUBE CANCER

2021 ◽  
Vol 34 (Supplement_1) ◽  
Author(s):  
Kazumasa Horie ◽  
Taro Oshikiri ◽  
Manabu Horikawa ◽  
Yu Kitamura ◽  
Gosuke Takiguchi ◽  
...  
Keyword(s):  
Supine Position ◽  
Gastric Tube ◽  
Postoperative Bleeding ◽  
Median Sternotomy ◽  
Gastric Conduit ◽  
Brachiocephalic Vein ◽  
R0 Resection ◽  
Left Brachiocephalic Vein ◽  
First Case ◽  
The Right

Abstract   Recent advances in treatment for esophageal cancer have improved prognosis after esophagectomy, but they have led to an increased incidence of gastric conduit cancer. In most gastric conduit cancer patients who underwent retrosternal reconstruction, median sternotomy is performed, which is associated with a risk of postoperative bleeding and osteomyelitis; pain often negatively affects respiration. To avoid these problems, we developed thoracoscopic retrosternal gastric conduit resection in the supine position (TRGR-S) as new procedure. Methods We performed the first case of TRGR-S for a 75-year-old male with retrosternal gastric conduit cancer. He was placed in the supine position. Four ports were placed in the left chest wall. The gastric conduit was separated from the epicardium, sternum, and left brachiocephalic vein. Due to adhesions between the gastric tube and the right pleura, combined resection of the right pleura was performed. Next, pediculated jejunal reconstruction via the presternal route was performed. Results Because there were few adhesions in the left thoracic cavity, this approach provided safety and a good surgical view, and it was easy to recognize the landmark including epicardium, sternum, and left brachiocephalic vein leading to appropriate resection of the tissue. Furthermore, there were few restrictions on the operative angle for the forceps and operability was quite ergonomic. Moreover, the lungs can be noninvasively contracted via an artificial pneumothorax. The pathological diagnosis was signet ring cell carcinoma (pT1b, pN0, M0, pStage I), indicating R0 resection. There were no post-operative complications. Conclusion This approach does not require sternotomy, so it has less risk of postoperative bleeding and osteomyelitis. Due to fewer adhesions, this approach is safe and provides a good surgical view. TRGR-S is a safe, ergonomic, and reliable procedure for resection of retrosternal gastric conduit cancer. Video This is the video of the operation ‘TRGR-S’, which is the new procedure for the gastric conduit cancer. https://www.dropbox.com/s/2whnekgp73hw1lz/video%20for%20ISDE2020.mov?dl=0.

scholarly journals Metachronous Gastric Tube Cancer After Esophagectomy with Gastric Pull-Up – Case Report

2020 ◽  
pp. 1-3
Author(s):  
M. Glanemann ◽  
Cristina Jorge ◽  
Susan Müller ◽  
S. Gafarli ◽  
D. Igna ◽  
...  
Keyword(s):  
Case Report ◽  
Cancer Survivor ◽  
Gastric Tube ◽  
Gastric Conduit ◽  
Prolonged Survival ◽  
Primary Adenocarcinoma ◽  
Second Primary ◽  
Gastric Tube Cancer ◽  
Secondary Tumors ◽  
Gastric Pull Up

The progresses in the therapy and methods of diagnosis of malignancies led to a prolonged survival and, consequently, to an increase in secondary tumors in cancer survivor patients [1-7]. We report the case of a 64-year-old patient who was diagnosed with a second primary adenocarcinoma in the gastric conduit, more than two years after the esophagectomy with gastric pull-up. We performed a resection of the gastric conduit and reconstructed with an ileocolon interposition.

Gastric tube cancer after esophagectomy for esophageal cancer: A single-center experience with meta-analysis of 145 cases.

2012 ◽  
Vol 30 (15_suppl) ◽  
pp. e14573-e14573
Author(s):  
Geun Dong Lee ◽  
Yong-Hee Kim ◽  
Seung-Il Park ◽  
Dong Kwan Kim ◽  
Hyeong Ryul Kim
Keyword(s):  
Esophageal Cancer ◽  
Surgical Resection ◽  
Endoscopic Resection ◽  
Gastric Tube ◽  
Palliative Treatment ◽  
Meta Analysis ◽  
Gastric Conduit ◽  
Survival Duration ◽  
Gastric Tube Cancer

e14573 Background: Gastric tube cancer (GTC) defined as carcinoma arising in the gastric conduit after esophagectomy, is often crucial in long-term survivors of esophageal cancer. The aim of this study was to determine the optimal approach to manage GTC. Methods: We reviewed data of 863 patients who underwent esophagectomy and reconstruction with the gastric conduit for esophageal cancer at Asan Medical Center from 1993 to 2011 and identified 28 cases of GTC. We also searched through the PubMed database and included additional 117 cases of GTC from 13 studies to conduct meta-analysis. Results: In our cases, the incidence rate of GTC was 3.2%. The median interval between esophagectomy and GTC detection was 3.1 (0.6-15.2) years. Twelve (42.9%) patients were asymptomatic and diagnosed by periodic endoscopy. The Most common histologic type of GTC was adenocarcinoma (57.1%) and fifteen (53.6%) were located on the lower third of gastric tube. Chemotherapy, total gastrectomy or palliative treatment was performed in 10, 5, 2 patients, respectively. Eleven (39.3%) patients refused the further treatment for GTC. Mean survival duration of 28 patients after the diagnosis of GTC was 29.1 months. In meta-analysis, The cumulative occurrence of 5, 8 years was 59.5%, 87.8%, respectively. Two-year survival rate of the patients who underwent endoscopic resection, surgical resection or palliative treatment was 100%, 61.6%, 5.2%, respectively. The patients who underwent endoscopic resection had a better prognosis than those who underwent surgical resection or those who received palliative treatment (p=0.047, p=0.000, respectively). Conclusions: After esophagectomy for esophageal cancer, patients had a constant risk of GTC occurrence up to 8 years approximately. The patients who diagnosed as advanced-state GTC had a poor prognosis. However, endoscopic resection as a minimally invasive treatment for early-GTC represented a feasible prognosis compared with those of operative resection or palliative treatment. Therefore, a long-term follow-up including detailed endoscopy is essential for the better outcomes in patients who underwent esophagectomy for esophageal cancer.

FA05.03: EFFECT OF EPHEDRINE ON GASTRIC CONDUIT PERFUSION MEASURED BY LASER SPECKLE CONTRAST IMAGING (LSCO) AFTER ESOPHAGECTOMY: A PROSPECTIVE IN-VIVO COHORT STUDY

2018 ◽  
Vol 31 (Supplement_1) ◽  
pp. 10-10
Author(s):  
Sanne Jansen ◽  
Daniel De Bruin ◽  
Simon Strackee ◽  
Mark I Van Berge Henegouwen ◽  
Ton Van Leeuwen ◽  
...  
Keyword(s):  
Anastomotic Leakage ◽  
Gastric Tube ◽  
Gastric Conduit ◽  
Laser Speckle ◽  
Contrast Imaging ◽  
Laser Speckle Contrast Imaging ◽  
Speckle Contrast ◽  
Before And After ◽  
Gastric Tube Reconstruction

Abstract Background Compromised perfusion due to ligation of arteries and veins in esophagectomy with gastric tube reconstruction often (5–20%) results in necrosis and anastomotic leakage, which relate to high morbidity and mortality (3–4%). Ephedrine is used widely in anesthesia to treat intra-operative hypotension and may improve perfusion by the increase of cardiac output (CO) and mean arterial pressure (MAP). This study tests the effect of ephedrine on perfusion of the future anastomotic site of the gastric conduit, measured by Laser Speckle Contrast Imaging (LSCI). Methods This prospective, observational, in-vivo pilot study includes 26 patients undergoing esophagectomy with gastric tube reconstruction from October 2015 to June 2016 in the Academic Medical Center (Amsterdam). Perfusion of the gastric conduit was measured with LSCI directly after reconstruction and after an increase of MAP by ephedrine 5 mg. Perfusion was quantified in flux (LSPU) in four perfusion locations, from good perfusion (base of the gastric tube) towards decreased perfusion (fundus). Intra-patient differences before and after ephedrine in terms flux were statistically tested for significance with a paired t-test. Results LSCI was feasible to image gastric microcirculation in all patients. Flux (LSPU) was significantly higher in the base of the gastric tube (791 ± 442) compared to the fundus (328 ± 187) (P < 0.001). After administration of ephedrine, flux increased significantly in the fundus (P < 0·05) measured intra-patients. Three patients developed anastomotic leakage. In these patients, the difference between measured flux in the fundus compared to the base of the gastric tube was high. Conclusion This study presents the effect of ephedrine on perfusion of the gastric tissue measured with LSCI in terms of flux (LSPU) after esophagectomy with gastric tube reconstruction. We show a small but significant difference between flux measured before and after administration of ephedrine in the future anastomotic tissue (313 ± 178 vs. 397 ± 290). We also show a significant decrease of flux towards the fundus. Disclosure All authors have declared no conflicts of interest.

PS02.204: GASTRIC TUBE CANCER AFTER ESOPHAGECTOMY FOR ESOPHAGEAL CANCER: A SYSTEMATIC REVIEW

2018 ◽  
Vol 31 (Supplement_1) ◽  
pp. 180-180
Author(s):  
Damiano Gentile ◽  
Pietro Riva ◽  
Anna Da Roit ◽  
Silvia Basato ◽  
Salvatore Marano ◽  
...  
Keyword(s):  
Esophageal Cancer ◽  
Gastric Tube ◽  
Conflicts Of Interest ◽  
Case Reports ◽  
Treatment Strategies ◽  
Vocal Cord Palsy ◽  
Review Literature ◽  
Gastric Tube Cancer ◽  
Publication Number

Abstract Background Gastric conduit used for reconstruction after esophagectomy for esophageal cancer (EC) has the potential to develop a metachronous cancer known as gastric tube cancer (GTC). The aim of our study was to review literature and evaluate outcomes and possible treatment strategies for GTC. Methods A comprehensive systematic literature search was conducted using PubMed. No restriction was set for type of publication, number, age and sex of patients. Study language was limited to English. Characteristics of EC and its treatment and GTC and its treatment were analyzed. Results A total of 26 studies were analyzed, 10 retrospective analysis and 16 case reports, involving 170 patients, 17 patients (10%) were affected by multifocal GTC. 143 ECs (84,1%) were squamous cell carcinomas. In 95 patients (55,9%) a posterior-mediastinal reconstructive route was used at the time of esophagectomy for EC. Mean interval between esophagectomy and diagnosis of GTC was 67,18 months (4–236 months). 184 GTCs were metachronous lesions (98,4%). 164 GTCs were adenocarcinomas (98,2%). 84 GTCs were located in the lower part of the gastric tube. 88 patients were endoscopically treated. 63 patients underwent surgery. 30 total gastrectomies + limphoadenectomy with colon or jejunal interposition were performed. 27 subtotal gastrectomies and 6 wedge resections were performed. Main reported post-operative complications were: anastomotic leak, vocal cord palsy and respiratory failure. 19 patients were treated with chemoradiotherapy and palliative care. 68,2% of endoscopically treated patients, 63,5% of surgically resected patients and 5,2% of patients who underwent chemoradiotherapy were alive at a mean follow-up of 25,5 months. Feasibility of endoscopic resections in patients diagnosed with superficial GTC has been established. Surgical treatment represents the preferred treatment modality in operable patients with locally invasive tumor. Patients treated with conservative therapy have a scarce prognosis. Conclusion Yearly endoscopic follow-up is of paramount importance in patients who underwent esophagectomy for EC with gastric tube reconstruction. At least, a 10-year endoscopic surveillance is recommended. Disclosure All authors have declared no conflicts of interest.

Endoscopic submucosal dissection for gastric tube cancer after esophagectomy

2014 ◽  
Vol 79 (2) ◽  
pp. 260-270 ◽  
Author(s):  
Satoru Nonaka ◽  
Ichiro Oda ◽  
Chiko Sato ◽  
Seiichiro Abe ◽  
Haruhisa Suzuki ◽  
...  
Keyword(s):  
Endoscopic Submucosal Dissection ◽  
Gastric Tube ◽  
Gastric Tube Cancer ◽  
Submucosal Dissection

Treating Gastric Tube Cancer With Distal Gastrectomy Preserving the Gastroepiploic Artery

2006 ◽  
Vol 81 (2) ◽  
pp. 751-753 ◽  
Author(s):  
Satoru Motoyama ◽  
Reijiro Saito ◽  
Manabu Okuyama ◽  
Kiyotomi Maruyama ◽  
Jun-ichi Ogawa
Keyword(s):  
Gastric Tube ◽  
Distal Gastrectomy ◽  
Gastroepiploic Artery ◽  
Gastric Tube Cancer
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