Case Report
Copyright ©2013 Baishideng Publishing Group Co., Limited. All rights reserved.
World J Gastroenterol. May 28, 2013; 19(20): 3169-3172
Published online May 28, 2013. doi: 10.3748/wjg.v19.i20.3169
Esophageal reconstruction with remnant stomach: A case report and review of literature
Song-Ping Xie, Guo-Hua Fan, Gan-Jun Kang, Qing Geng, Jie Huang, Bang-Chang Cheng
Song-Ping Xie, Guo-Hua Fan, Gan-Jun Kang, Qing Geng, Jie Huang, Bang-Chang Cheng, Department of Thoracic Surgery, Renmin Hospital of Wuhan University, Wuhan 430060, Hubei Province, China
Author contributions: Xie SP, Huang J and Cheng BC designed the report; Xie SP, Fan GH, Kang GJ and Geng Q managed the patients; Huang J performed surgical operation; Xie SP, Huang J and Cheng BC organized the report; Xie SP wrote paper.
Correspondence to: Jie Huang, MD, Department of Thoracic Surgery, Renmin Hospital of Wuhan University, 99 Zhangzhidong Road, Wuchang District, Wuhan 430060, Hubei Province, China. doctor_xie @hotmail.com
Telephone: +86-27-88041911 Fax:+86-27-88041911
Received: January 20, 2013
Revised: March 27, 2013
Accepted: April 9, 2013
Published online: May 28, 2013
Abstract

The number of patients developing esophageal cancer after gastrectomy has increased. However, gastric remnant is very rarely used for reconstruction in esophageal cancer surgery because of the risk of anastomotic leakage resulting from insufficient blood flow. We present a case of esophageal cancer using gastric remnant for esophageal substitution after distal gastrectomy in a 57-year-old man who presented with a 1-month history of mild dysphagia and a background history of alcohol abuse. Gastroscopy showed a 1.2 cm × 1.0 cm bulge tumor of the lower third esophagus with the upper margin located 39 cm from the dental arcade. Computed tomography of the chest showed lower third esophageal wall thickening. The patient underwent en bloc radical esophagectomy with a two-field lymph node dissection of the upper abdomen and mediastinum via a left-sided posterolateral thoracotomy through the seventh intercostal space. The upper end of the esophagus was resected 5 cm above the tumor. The gastric remnant was used for reconstruction of the esophago-gastrostomy and placed in the left thoracic cavity. The patient started a liquid diet on postoperative day 8 and was discharged on the 10th postoperative day without complications. In this report, we demonstrate that the gastric remnant may be used for reconstruction in patients with esophageal cancer as a substitute organ after distal gastrectomy.

Keywords: Gastric remnant, Distal, Gastrectomy, Esophageal cancer, Substitution

Core tip: Gastric remnant is very rarely used for reconstruction in esophageal cancer surgery because of the risk of anastomotic leakage resulting from insufficient blood flow. We present a case of esophageal cancer using gastric remnant for esophageal substitution after distal gastrectomy in a 57-year-old man, who was successfully treated with esophagectomy and remnant stomach reconstruction without micro-vascular anastomosis. The gastric remnant may be used for reconstruction in patients with esophageal cancer as a substitute organ after distal gastrectomy, with rapid recovery of bowel function and shorter hospital stay.