3. 食道癌術後再建臓器血行障害に対する再手術

Re-operation for Blood Circulation Disorder of Reconstructive Organ after Esophageal Cancer Surgery

インドシアニングリーン（ICG）蛍光法などの導入により，術中に食道癌再建臓器の血流を評価することが可能となった1）．これにより術後再建臓器壊死というような激しい再建臓器血流障害の合併症を経験する機会は少なくなった．しかしながらそれでも，まれには再建臓器の血流障害で再手術を含めた治療法の選択に悩むことは起こりうる．本稿では食道癌術後再建臓器の中で，もっとも使用頻度が高い胃管の血流障害に対する再手術の適応と，実施する際の注意点，術後管理について概説する．

With the introduction of indocyanine green （ICG） fluorescence and other techniques, it has become possible to evaluate intraoperative blood flow of the reconstructed organ of esophageal cancer surgery. This has reduced critical complications such as postoperative necrosis of the reconstructed organ. However, there is still the possibility of experiencing rare blood circulation disorders of reconstructive organs, which may lead to a difficult treatment choice, including reoperation. This article reviews the indications for reoperation, the precautions to be taken, and the postoperative management of the most frequently used reconstructive organ, the gastric tube.