A DISTAL GASTRECTOMY FOR CARCINOMA DEVELOPED IN THE RECONSTRUCTED GASTRIC TUBE 13 YEARS AFTER ESOPHAGECTOMY FOR THORACIC ESOPHAGEAL CANCER -A CASE REPORT-

We report a resected case of carcinoma developed in the reconstructed gastric tube 13 years after esophagectomy for a thoracic esophageal cancer. In February, 1984, he underwent a subtotal esophagectomy and an intrathoracic esophagostrostomy for an early carcinoma in the middle intra-thoracic esophagus (Im). The tumor was superficial and flat type, 2.0×1.5cm in size, and microscopically squamous cell carcinoma (sec) with m, n0, v0, ly0, and in stage 0. Since September, 1996 he had experienced chest discomfort and appetite loss. He visited the department of internal medicine in our hospital, and a pace maker was implanted for sick sinus syndrome in February, 1997. The symptom was not improved and an endoscopic examination showed a gastric carcinoma of type 5 in the lesser curvature of the antrum. So he was referred to the department in March, 1997. Preserving the right gastroepiploic artery and vein, a distal gastrectomy and a Roux-en-Y anastomosis for the remnant stomach and jejunum were performed. Histologically, the tumor was well-differentiated adenocarcinoma with tubl, ss, n(-), ly1, v1, in stage Ib. As of 12 months after the operation, the patient is disease-free without an signs of recurrence. Some bibliographical notes on 65 cases of carcinoma in the gastric tube reconstructed after esophagectomy in Japan are also presented.