Resection of gastric tube cancer after retrosternal reconstruction : Usefulness of laparoscopic mediastinal approach Keita HANADA 1 , Hiroaki HATA 1 , Masashi SAJI 1 , Takashi YAMAGUCHI 1 , Tetsushi OTANI 1 , Iwao IKAI 1 1Department of Surgery, National Hospital Organization Kyoto Medical Center Keyword: 胃管癌 , 胸骨後経路再建 , 腹腔鏡下縦隔アプローチ pp.347-353
Published Date 2017/5/15
DOI https://doi.org/10.11477/mf.4426200410
  • Abstract
  • Look Inside
  • Reference

We encountered a 66-year-old man with gastric tube cancer after retrosternal reconstruction who underwent gastric tube resection through a laparoscopic mediastinal approach. Right transthoracic subtotal esophagectomy with gastric tube reconstruction through a retrosternal route had been performed for esophageal cancer at the age of 53 years; total laryngopharyngectomy combined with cervical esophagectomy and free jejunum reconstruction were performed for laryngeal cancer at the age of 63 years. He was diagnosed with gastric tube cancer on follow-up studies 3 years later, and underwent surgery. We initially approached the gastric tube laparoscopically and dissected adhesions between the gastric tube and pleura, pericardium, and sternum. We then incised the skin at the neck and extended the dissected space from the neck to the mediastinum. After transection of the reconstructed jejunum, the gastric tube was moved to the peritoneal cavity. Reconstruction was performed with the left hemicolon. The laparoscopic mediastinal approach was useful for resection of the retrosternal gastric tube, with less invasiveness and better view, through adequate preoperative planning of port positions and preparation of surgical instruments.

Copyright © 2017, JAPAN SOCIETY FOR ENDOSCOPIC SURGERY All rights reserved.


電子版ISSN 2186-6643 印刷版ISSN 1344-6703 日本内視鏡外科学会