Sentinel node navigation surgery with indocyanine green fluorescence-guided method for metachronous early gastric carcinoma arising from reconstructed gastric tube after esophagectomy

A 67-year-old man who had undergone a thoracoscopic esophagectomy and posterior mediastinal gastric tube reconstruction for thoracic esophageal cancer 9 years previously was endoscopically diagnosed as having gastric carcinoma arising from the reconstructed gastric tube. No evidence of metastasis was seen in imaging examinations, and the depth of tumor invasion was suspected to be the submucosal layer. Based on these results, we decided that surgery, rather than endoscopic resection, was indicated. The tumor was located in the upper abdomen. Therefore, we performed a partial resection of the gastric tube. Sentinel nodes (SN) were identified using the Hyper Eye Medical System II. Metastasis was not observed in any of the selected SN. While the treatment strategy for gastric tube cancer after an esophagectomy remains controversial, minimally invasive surgery with sentinel node navigation surgery appears to be clinically useful. However, the method of SN dissection should be investigated with due consideration given to arterial preservation.