scholarly journals Heterochronous Suture Line Recurrences in the Jejunal Pouch following Total Gastrectomy for Stage II Gastric Cancer: A Case Report and Literature Review

2020 ◽  
Vol 13 (1) ◽  
pp. 225-232
Author(s):  
Takamichi Yokoe ◽  
Michio Sato ◽  
Masashi Yahagi ◽  
Murat Dogru ◽  
Hiroto Fujisaki ◽  
...  
Keyword(s):  
Gastric Cancer ◽  
Total Gastrectomy ◽  
Suture Line ◽  
Stage Ii ◽  
Resection Margins ◽  
Jejunal Pouch ◽  
Local Recurrences ◽  
J Pouch ◽  
The Common ◽  
Histopathological Subtype

We report the case of a 65-year-old male who developed heterochronous local recurrences of gastric cancer in the jejunal pouch (J-pouch) four times after total gastrectomy. He underwent total gastrectomy, J-pouch, and Roux-en-Y reconstruction for stage II gastric cancer in 2005. Four local recurrences appeared on the esophago-jejunal anastomosis, the suture line within the pouch, the esophago-jejunal anastomosis, and the anastomosis between the jejunum and Y-loop, which were resected by partial excision or endoscopic submucosal dissection. Suture line recurrence of gastric cancer is rare. The common features for each recurrence included the surgically negative resection margins, observation of the same histopathological subtype, absence of remote metastasis or peritoneal seeding, and the recurrence on the anastomotic suture line, suggesting that the cause of recurrence was the implantation of exfoliated cancer cells probably in the suture line. However, there is no established procedure for preventing implantation recurrence currently, the effectiveness of lumen lavage is suggested.

scholarly journals Suture line recurrence in jejunal pouch replaced after total gastrectomy for gastric cancer

1999 ◽  
Vol 2 (3) ◽  
pp. 194-197 ◽  
Author(s):  
Kazuya Miyoshi ◽  
Sadanori Fuchimoto ◽  
Toshihide Ohsaki ◽  
Tatsuhiko Sakata ◽  
Isao Takeda ◽  
...  
Keyword(s):  
Gastric Cancer ◽  
Total Gastrectomy ◽  
Suture Line ◽  
Jejunal Pouch

scholarly journals Surgical Management of Gastric Cancer: An Institutional Experience

2019 ◽  
Vol 17 (2) ◽  
pp. 82-85
Author(s):  
Anup Sharma ◽  
Pradip Thapa
Keyword(s):  
Gastric Cancer ◽  
Metastatic Disease ◽  
Stage Iv ◽  
Radical Resection ◽  
Stage Ii ◽  
Stage Iii ◽  
Gastrointestinal Malignancies ◽  
Female Ratio ◽  
Screening Programs ◽  
The Common

Introduction: Gastric cancer (GC) is the second most common cause of cancer-related deaths causing about 800,000 deaths worldwide/year. In Nepal gastric cancer is the second common cancer among males after the lung cancer. Gastric cancer shows a wide variation in incidence worldwide, being highest in Korea and Japan. It is detected early due to the low threshold for upper gastrointestinal endoscopy and screening programs. In the rest of the world and particularly in developing countries, GC is advanced in most of the cases. Inspite of controversies in extent of resection and lymphadenectomy, surgery remains the gold standard treatment. The study was conducted to determine the outcome of the patients with gastric cancer. Methods: The study was conducted in the department of surgery at Nepalgunj Medical College and Teaching Hospital Kohalpur from November 2015 to Dec 2018. Patients diagnosed with GC were studied. The patients with resectable disease underwent radical resection followed by adjuvant chemo-radiation as indicated. Patient’s demography, clinical presentation, stage of disease, types of surgery performed and survival were analysed. Results: 58 patients were diagnosed with gastric cancer. The age ranged from 20-83 years with the mean of 61.26±11.28. Male to female ratio was 2.41: 1. The common clinical presentations were weight loss, anorexia and anemia, 17 (29.31%) had gastric outlet obstruction at initial presentation and 4 (6.89%) presented with perforation peritonitis. Antropyloric region was the commonest site of tumor location seen in 41 (70.68%). 7 (12.06%) patients had distant metastasis and 5 (8.62%) had ascites at presentation. Out of 58 patients, 43 (74.13%) were operated. Only 18 (41.86%) patients underwent R0 resection. 14 (24.13%) underwent palliative gastrojejunostomy. Two (3.44%) patients underwent primary repair for perforation and in 9 (15.51%) the procedure was abandoned due to and presence of metastasis. There was one post-operative mortality. The histology of gastric cancer was found to be adenocarcinoma in all patients. There was no patient in stage I. 3(16.66%) patients were in stage II and 15 (83.33%) in stage III. 17 (29.31%) had stage IV disease. Out of 43 operated patients, 13 lost follow up. All 17 resected patients and those with metastatic disease were followed up. There was no death and no local recurrence in stage II. In stage III, 78.57% were alive and in stage IV 35.29% were alive. Conclusion: Gastric cancer is one of the common gastrointestinal malignancies affecting predominantly male gender. Stage of the disease is one of the major prognostic factors related with the survival. Adenocarcinoma is the commonest histology. Radical resection followed by adjuvant chemotherapy is the standard of care. Palliative chemotherapy can prolong the overall survival in patients with metastatic disease.

scholarly journals A Long-Term Follow-Up Result of Pouch Plasty for Severe Dysfunction of Jejunal Pouch Reconstruction After Total Gastrectomy: A Case Report

2015 ◽  
Vol 100 (5) ◽  
pp. 954-957 ◽  
Author(s):  
Takafumi Tamura ◽  
Satoshi Inagawa ◽  
Hideo Terashima ◽  
Yoshimasa Akashi ◽  
Katsuji Hisakura ◽  
...  
Keyword(s):  
Total Gastrectomy ◽  
Jejunal Pouch ◽  
J Pouch ◽  
Long Term Follow Up ◽  
Pouch Reconstruction ◽  
Epigastric Distress ◽  
Jejunal Pouch Reconstruction ◽  
To Receive

A 78-year-old woman with malignant lymphoma of the stomach underwent total gastrectomy with a jejunal-pouch (J-pouch) reconstruction in 1994. Twelve years after surgery the patient began to suffer epigastric distress and reflux symptoms. Eventually, she was unable to take anything by mouth. A series of diagnostic images seemed to indicate that the main cause of the dysfunction was flaccidity of the J-pouch and deformity of the outflow route induced by chronic excessive dilatation of the pouch wall. Because all conservative managements only led to temporary improvement and ended in failure, she hoped to receive the operation. We designed “pouch plasty” capable of ameliorating the pouch dysfunction. The aim of pouch plasty was to improve uneven tension of the pouch wall and repair deformity of the outflow route of the food. After the operation, the J-pouch resumed adequate drainage and had good reservoir function. More than 7 years later, the patient had no further complications.

scholarly journals Laparoscopic Total Gastrectomy for Early Gastric Cancer With a Rare Positional Abnormality of the Common Hepatic Artery and Splenic Vein: A Case Report

2020 ◽  
Vol 104 (1-2) ◽  
pp. 65-68
Author(s):  
Masahiro Kataoka ◽  
Masato Kitazawa ◽  
Shyuugo Takahata ◽  
Nao Hondo ◽  
Shugo Takahata ◽  
...  
Keyword(s):  
Gastric Cancer ◽  
Computed Tomography ◽  
Total Gastrectomy ◽  
Hepatic Artery ◽  
Splenic Vein ◽  
Laparoscopic Total Gastrectomy ◽  
Common Hepatic Artery ◽  
Vascular Abnormality ◽  
The Common ◽  
Running Pattern

Introduction: We report a case of successful laparoscopic total gastrectomy with very rare vascular abnormality. Case presentation: A 35-year-old woman was diagnosed with early gastric cancer through a medical checkup. A preoperative computed tomography scan revealed positional variation of the common hepatic artery and splenic vein. The common hepatic artery branched normally from the celiac artery, but the splenic vein was located anterior to it. The patient was successfully treated via laparoscopic total gastrectomy without surgical complications. Conclusion: This vascular abnormality is extremely rare, and to our knowledge, there is no report of surgical cases with this vascular variation. Because of the difficulty in confirming the running pattern of the artery intraoperatively, it is important to ascertain the arterial running pattern preoperatively using computed tomography, including 3-dimensional angiographic imaging.

scholarly journals Jejunal Pouch Double-Tract Reconstruction after Total Gastrectomy for Gastric Cancer

2005 ◽  
Vol 38 (6) ◽  
pp. 585-591
Author(s):  
Yasuyuki Kawachi ◽  
Takeaki Shimizu ◽  
Keiya Nikkuni ◽  
Atsushi Nishimura ◽  
Kazuhiko Tsunoda ◽  
...  
Keyword(s):  
Gastric Cancer ◽  
Total Gastrectomy ◽  
Jejunal Pouch ◽  
Double Tract Reconstruction

scholarly journals Jejunal Pouch Double Tract versus Reux-en-Y Reconstruction after Total Gastrectomy for Gastric Cancer.

1999 ◽  
Vol 32 (4) ◽  
pp. 978-982
Author(s):  
Yasumasa Kondoh ◽  
Yasuo Kajiura ◽  
Kenji Nakamura ◽  
Masao Miyaji ◽  
Kyoji Ogoshi ◽  
...  
Keyword(s):  
Gastric Cancer ◽  
Total Gastrectomy ◽  
Jejunal Pouch

An autopsy case of primary jejunal pouch cancer which protruded from the abdominal wall 14 years after total gastrectomy for gastric cancer

2020 ◽  
Vol 13 (6) ◽  
pp. 1091-1095
Author(s):  
Yuki Kanayama ◽  
Hitoshi Takagi ◽  
Satoshi Takakusagi ◽  
Yozo Yokoyama ◽  
Kazuko Kizawa ◽  
...  
Keyword(s):  
Gastric Cancer ◽  
Abdominal Wall ◽  
Total Gastrectomy ◽  
Autopsy Case ◽  
Jejunal Pouch ◽  
Pouch Cancer
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