A RESECTED CASE OF GASTRIC CANCER ARISEN IN THE GASTRIC TUBE 19 YEARS AFTER OPERATION FOR ESOPHAGEAL CANCER

This paper presents a resected case of gastric cancer arisen in the gastric tube which was elevated via retrosternal route at an operation for esophageal cancer 19 years before. The operation for the esophageal cancer was performed on December 19, 1979, when it was Mt-Lt, pT2, pN2, and in pStage III. The patient had been recurrence-free until January 1998, when the patient was admitted to the hospital because of dysphagia. Massive anal bleeding also occurred. As a result of close examination, cancer of the gastric tube was pointed out. The problems lay in the route elevating the gastric tube and the shortness of the remnant esophagus. However, there is a report ensuring that the primary feeding vessels can be dissected, and so we decided to carry out an operation. At operation, the right gastroomental artery was dissected under a median sternotomy and was resected at 6cm distal to the gastric tube. Reconstruction was made by using the ileum and right side colon involving the rihght colonic artery and middle colic artery as vascular pedicles, with a successful outcome.