Gastric Conduit Ulcer Pentration into the Right Middle Lobe after Esophageal Cancer Surgery;Report of a Case Hiroshi Hosoda 1 , Yu Kawada 1 , Yusuke Tatsutomi 1 , Sachiko Imai 2 1Department of Thoracic Surgery, Tokyo Kyosai Hospital Keyword: gastropulmonary fisutula , peptic ulcer of gastric conduit , complication after esophagectomy for esophageal cancer , parasternal incision pp.557-559
Published Date 2020/7/1
DOI https://doi.org/10.15106/j_kyobu73_557
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A 55-year-old man with esophageal cancer underwent esophagectomy along with lymph node dissection and reconstruction with gastric conduit through the sternal route. He developed a continuous cough with sputum production, 3 years postoperatively. Chest radiography revealed a right middle lung field infiltrate. Chest computed tomography revealed communication between the reconstructed esophagus and the gastric conduit (pull-up) and right middle lobe airways.

Upper gastrointestinal examination revealed ulcerative lesions involving the gastric mucosa;however, biopsy of the ulcer showed no malignancy. Conservative therapy including fasting and proton-pump inhibitor administration did not improve symptoms caused by gastropleural fistula. Thoracotomy was performed through the anterolateral intercostal space under the right-up supine position, and the partial lung resection and direct closure of the stomach with muscle flap wrapping was performed.

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