Subtotal gastrectomy for gastric tube cancer after esophagectomy: a safe procedure preserving the proximal part of gastric tube based on intraoperative ICG blood flow evaluation

Journal of Surgical Oncology
Takuro SaitoOsamu Ishikawa

Abstract

Recent improvements in the survival of patients after esophagectomy have led to an increase in the occurrence of gastric tube cancer (GTC). Total resection of the gastric tube with lymphadenectomy is a standard and reliable treatment for GTC, but problems may arise during or after surgery, such as laryngeal nerve injury, reduced selection of organs for reconstruction, and impaired swallowing function. We recently performed a less invasive procedure, subtotal gastrectomy with preservation of the upper region of the gastric tube, in two patients. In these patients, blood supply to the gastric tube was evaluated by indocyanine green fluorescence imaging. Blood flow was confirmed as passing from the remnant esophagus to the upper region of the gastric tube through the esophago-gastric anastomotic site by indocyanine green fluorescence imaging. Therefore, we resected the gastric tube while preserving the upper region of the gastric tube. There was no necrosis of the remnant gastric tube or anastomotic leakage postoperatively, and postoperative swallowing and eating functions were quite good in both patients. In summary, subtotal gastrectomy as a treatment for GTC is potentially safe, curative, and beneficial for the patient's qualit...Continue Reading

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Citations

Apr 23, 2013·Contrast Media & Molecular Imaging·Dawid MurawaPawel Murawa
May 23, 2014·Interactive Cardiovascular and Thoracic Surgery·Yaxing ShenQun Wang
Jan 30, 2015·World Journal of Surgical Oncology·Yasumichi YagiHikaru Oguri
Jun 26, 2018·Journal of Surgical Oncology·Labrinus van ManenJan Sven David Mieog
Jan 10, 2018·ANZ Journal of Surgery·Yota KawasakiShoji Natsugoe
May 22, 2019·Diseases of the Esophagus : Official Journal of the International Society for Diseases of the Esophagus·Damiano GentileCarlo Castoro
Oct 5, 2019·Asian Journal of Endoscopic Surgery·Kazumasa HorieYoshihiro Kakeji
Aug 15, 2020·The Korean Journal of Thoracic and Cardiovascular Surgery·Yu Hua QuanHyun Koo Kim
Sep 8, 2021·Langenbeck's Archives of Surgery·Kaja LudwigTilman Pickartz

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