Residual esophageal necrosis after radical esophagectomy for esophagogastric cancer: A case report

Tabe,Shunsuke; Hoshino,Isamu; Takiguchi,Nobuhiro; Ikeda,Atsushi; Soda,Hiroaki; Tonooka,Toru; Gunji,Hisashi; Nabeya,Yoshihiro; Otsuka,Masayuki

doi:10.3892/mco.2020.1997

April-2020 Volume 12 Issue 4

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April-2020 Volume 12 Issue 4

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Case Report Open Access

Residual esophageal necrosis after radical esophagectomy for esophagogastric cancer: A case report

Authors:
- Shunsuke Tabe
- Isamu Hoshino
- Nobuhiro Takiguchi
- Atsushi Ikeda
- Hiroaki Soda
- Toru Tonooka
- Hisashi Gunji
- Yoshihiro Nabeya
- Masayuki Otsuka
View Affiliations / Copyright

Affiliations: Department of Gastroenterological Surgery, Chiba Cancer Center, Chiba 260‑8717, Japan

Copyright: © Tabe et al. This is an open access article distributed under the terms of Creative Commons Attribution License.
Pages: 321-324
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Published online on: February 18, 2020

https://doi.org/10.3892/mco.2020.1997
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Abstract

A 66‑year‑old man was diagnosed with advanced esophagogastric junction cancer and referred to our institution (Department of Gastroenterological Surgery, Chiba Cancer Center) for treatment. Computed tomography imaging confirmed the presence of a tumor, extending from the lower thoracic esophageal to the esophagogastric junction, with swelling of the upper mediastinal lymph nodes. Based on the criteria of the International Union against Cancer Committee (UICC, 8th Edition), the staging was confirmed as follows: 101R, 107 and 106 pre. Based on these findings, a clinical diagnosis of EGJ cancer was made, with a UICC8th classification of cT3N1M0 c‑stage‑III. Preoperative chemotherapy was performed, with tumor shrinkage obtained after three courses of chemotherapy (using S‑1 plus oxaliplatin). Subsequently, esophagectomy with three‑field lymph node dissection and gastric tube reconstruction, via the intrathoracic route, was performed. On postoperative day 2, the patient developed an idiopathic pneumothorax, with brown‑green drainage from the chest tube. A repeat thoracotomy was performed, confirming the presence of brown‑green pleural fluid and necrosis of esophageal tissue. The area of necrosis was situated 4 cm on the oral side of the anastomosis, with greater necrosis of the right than left side. There was no evidence of necrosis of the gastric tube. The necrotic residual esophagus was excised and reconstructed, as an external fistula on the left side of the neck. On day 38, after the second surgery, reconstruction of the esophageal conduit and gastric tube, via the jejunum, was performed. At 7 months after discharge, the patient was symptom free, with no evidence of cancer recurrence.

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Journals

International Journal of Molecular Medicine

International Journal of Oncology

Molecular Medicine Reports

Oncology Reports

Experimental and Therapeutic Medicine

Oncology Letters

Biomedical Reports

Molecular and Clinical Oncology

World Academy of Sciences Journal

International Journal of Functional Nutrition

International Journal of Epigenetics

Medicine International

Residual esophageal necrosis after radical esophagectomy for esophagogastric cancer: A case report

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