ID 5737
File
Authors
Miyauchi, Wataru Division of Surgical Oncology, Department of Surgery, School of Medicine, Tottori University Faculty of Medicine
Shishido, Yuji Division of Surgical Oncology, Department of Surgery, School of Medicine, Tottori University Faculty of Medicine Researchers DB
Kono, Yusuke Division of Surgical Oncology, Department of Surgery, School of Medicine, Tottori University Faculty of Medicine
Murakami, Yuki Division of Surgical Oncology, Department of Surgery, School of Medicine, Tottori University Faculty of Medicine Researchers DB
Kuroda, Hirohiko Division of Surgical Oncology, Department of Surgery, School of Medicine, Tottori University Faculty of Medicine KAKEN
Fukumoto, Yoji Division of Surgical Oncology, Department of Surgery, School of Medicine, Tottori University Faculty of Medicine Researchers DB KAKEN
Osaki, Tomohiro Division of Surgical Oncology, Department of Surgery, School of Medicine, Tottori University Faculty of Medicine KAKEN
Sakamoto, Teruhisa Division of Surgical Oncology, Department of Surgery, School of Medicine, Tottori University Faculty of Medicine Researchers DB
Honjo, Soichiro Division of Surgical Oncology, Department of Surgery, School of Medicine, Tottori University Faculty of Medicine Researchers DB
Ashida, Keigo Division of Surgical Oncology, Department of Surgery, School of Medicine, Tottori University Faculty of Medicine Researchers DB KAKEN
Saito, Hiroaki Division of Surgical Oncology, Department of Surgery, School of Medicine, Tottori University Faculty of Medicine Researchers DB KAKEN
Fujiwara, Yoshiyuki Division of Surgical Oncology, Department of Surgery, School of Medicine, Tottori University Faculty of Medicine Researchers DB KAKEN
Keywords
blood-flow evaluation
esophageal carcinoma
indocyanine green
intra-operative
remnant gastric cancer
Abstract
The standard procedure for remnant gastric cancer after esophago-proximal gastrectomy is total resection of the remnant stomach considering blood supply. However, sometimes surgery may be too invasive due to severe adhesion in the thoracic and mediastinal cavity. The blood supply to the remnant stomach depends on the right gastroepiploic artery and the right gastric artery. Therefore, preservation of the proximal region of the remnant stomach is thought to be anatomically impossible. We report a case of remnant gastric cancer that developed more than 12 years after lower thoracic esophagectomy plus proximal gastrectomy for Siewert Type I squamous cell carcinoma. We used intra-operative indocyanine green (ICG) venous-injection to evaluate blood flow and distal gastrectomy of the remnant stomach was performed by preserving the proximal stomach in the thoracic cavity through an abdominal approach. There were no complications of the remnant stomach or the anastomosis to the jejunum after surgery. In this case, we focused on the blood supply by collateral circulation through the anastomotic line from the remnant esophagus. After confirming blood supply with intra-operative evaluation using ICG fluorescence, less-invasive distal gastrectomy was successfully performed. As the intra-operative ICGbased evaluation for blood supply is a simple and safe method, it might be useful for determining the resection margin of various organs and be effective for the introduction of less invasive surgery. Here, we report a case and a review of the literature.
Publisher
Tottori University Faculty of Medicine
Content Type
Journal Article
ISSN・ISBN
13468049
NCID
AA00892882
Journal Title
Yonago Acta Medica
Current Journal Title
Yonago Acta Medica
Volume
61
Issue
3
Start Page
187
End Page
191
Published Date
2018
Text Version
Publisher
Rights
注があるものを除き、この著作物は日本国著作権法により保護されています。
Citation
Yonago Acta Medica. 2018, 61(3), 187-191
Department
Faculty of Medicine/Graduate School of Medical Sciences/University Hospital
Language
English