2024-03-29T00:06:37Z
https://nagoya.repo.nii.ac.jp/oai
oai:nagoya.repo.nii.ac.jp:00028744
2023-11-16T02:59:21Z
499:508:509:2445
Esophageal reconstruction using a pedicled jejunum following esophagectomy for metastatic esophageal stricture from breast cancer in a patient with previous pancreatoduodenectomy
Asai, Soichiro
Fukaya, Masahide
Fujieda, Hironori
Igami, Tsuyoshi
Tsunoda, Nobuyuki
Sakatoku, Yayoi
Kamei, Yuzuru
Miyata, Kazushi
Nagino, Masato
open access
Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International
pancreatoduodenectomy
thoracoscopic esophagectomy
breast cancer
metastatic esophageal stricture
A 71-year-old woman with dysphagia was diagnosed with thoracic esophageal squamous cell carcinoma by endoscopic biopsy at another hospital. She had previously undergone partial breast excision with axillary lymph node dissection for right breast cancer eleven years earlier and subtotal stomach-preserving pancreatoduodenectomy with Child’s reconstruction for ampullary cancer ten years earlier. Gastrointestinal endoscopy showed a stricture due to a bulging submucosal tumor in the mid-thoracic esophagus. The tumor was diagnosed as an esophageal metastasis from breast cancer by endoscopic ultrasound-guided fine-needle aspiration biopsy. After six courses of fulvestrant, the tumor progressed, completely impeding her ability to swallow. An esophagectomy was planned in a one-stage operation because of the expectation of a prolonged survival and her strong hope of regaining oral intake. Unfortunately, she underwent emergent omental patch repair for perforation of the gastrojejunostomy site due to an anastomotic ulcer one day before the scheduled operation. Due to postoperative impairment of her performance status, she subsequently underwent a two-stage esophageal operation. In the first surgical stage, prone position thoracoscopic esophagectomy and cervical esophagostomy were performed and she was discharged with enteral nutrition on postoperative day 15. Sixty-one days after the first surgical stage, esophageal reconstruction was performed using a pedicled jejunum with microvascular anastomosis via the subcutaneous route. She was discharged without any complications 20 days after the second operation.
Nagoya University Graduate School of Medicine, School of Medicine
2019-11
eng
departmental bulletin paper
VoR
https://doi.org/10.18999/nagjms.81.4.679
http://hdl.handle.net/2237/00030931
https://nagoya.repo.nii.ac.jp/records/28744
10.18999/nagjms.81.4.679
http://www.med.nagoya-u.ac.jp/medlib/nagoya_j_med_sci/814.html
2186-3326
0027-7622
Nagoya Journal of Medical Science
81
4
679
685
https://nagoya.repo.nii.ac.jp/record/28744/files/14_Asai.pdf
application/pdf
36.1 MB
2019-11-26