Retrospective Study
Copyright ©The Author(s) 2015. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastroenterol. Jan 21, 2015; 21(3): 919-925
Published online Jan 21, 2015. doi: 10.3748/wjg.v21.i3.919
Clinical characteristics and management of gastric tube cancer with endoscopic submucosal dissection
Michita Mukasa, Hidetoshi Takedatsu, Ken Matsuo, Hiroaki Sumie, Hikaru Yoshida, Atsushi Hinosaka, Yasutomo Watanabe, Osamu Tsuruta, Takuji Torimura
Michita Mukasa, Hidetoshi Takedatsu, Ken Matsuo, Hiroaki Sumie, Hikaru Yoshida, Atsushi Hinosaka, Yasutomo Watanabe, Osamu Tsuruta, Takuji Torimura, Division of Gastroenterology, Department of Medicine, Kurume University School of Medicine, 67 Asahi-machi, Kurume, Fukuoka 830-0011, Japan
Author contributions: Mukasa M, Matsuo K, Sumie H, Yoshida H, Hinosaka A and Watanabe Y performed the majority of the experiments; Takedatsu H, Tsuruta O and Torimura T designed the study and wrote the manuscript.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Hidetoshi Takedatsu, MD, PhD, Division of Gastroenterology, Department of Medicine, Kurume University School of Medicine, 67 Asahi-machi, Kurume, Fukuoka 830-0011, Japan. takedatsu_hidetoshi@kurume-u.ac.jp
Telephone: 81-942-353311 Fax: +81-942-342623
Received: June 5, 2014
Peer-review started: June 6, 2014
First decision: July 27, 2014
Revised: July 22, 2014
Accepted: September 18, 2014
Article in press: September 19, 2014
Published online: January 21, 2015
Abstract

AIM: To identify the characteristics of gastric tube cancer (GTC) and the complications associated with endoscopic submucosal dissection (ESD) for GTC.

METHODS: Between 2007 and 2012, 11 individuals with early gastric cancer in the reconstructed gastric tube after esophagectomy who underwent ESD in this hospital were studied. The characteristics of GTC were identified, and the complications of ESD for GTC were analyzed at three phases: preoperative, intraoperative, and postoperative.

RESULTS: A total of 11 consecutive patients with 11 GTCs were selected for this study. All cases underwent en bloc resections by ESD. The median procedure time was 142 min. The average GTC diameter was 26.1 mm, and the average size of the resected lesions was 45.5 mm. The histopathological diagnosis in all cases was a differentiated adenocarcinoma. In the preoperative phase, anastomotic strictures (5/11, 45%) and food residues (4/11, 36.4%) in the gastric tube were the main complications. In the intraoperative phase, bleeding was observed in 5 cases (45%). The postoperative complications observed were delayed bleeding in 2 cases (18.2%) and stenosis in one case (9.1%). The case with stenosis was successfully treated using endoscopic balloon dilatation.

CONCLUSION: Minor complications were frequently observed. However, all GTCs underwent en bloc resection with ESD without any serious complications. ESD is considered a useful treatment for GTC.

Keywords: Gastric tube cancer, Endoscopic submucosal dissection, Complications, Endoscopy, Esophagectomy

Core tip: The pulled-up stomach conduit, when reconstructed and used as an esophageal substitute after esophagectomy, has the potential to develop gastric tube cancer (GTC). Although endoscopic submucosal dissection (ESD) for early gastric cancer is common, there are only a few reports on ESD for GTC. In this study, we identified the characteristics of GTC and the complications associated with ESD for GTC. Minor complications, such as anastomotic stricture, food residue, and intraoperative bleeding, were frequently observed. However, all GTCs were safely resected en bloc with ESD without serious complications. ESD can be considered a useful treatment modality for GTC.