caa a22 4500 606204431 CHVBK 20210128101002.0 cr unu---uuuuu 210128e20150701xx s 000 0 eng 10.1007/s10388-014-0426-8 doi (NATIONALLICENCE)springer-10.1007/s10388-014-0426-8 Esophagectomy with gastric tube reconstruction for patients who previously underwent free jejunal transfer [Elektronische Daten] [Atsushi Shiozaki, Hitoshi Fujiwara, Hirotaka Konishi, Takeshi Ishimoto, Ryo Morimura, Yasutoshi Murayama, Shuhei Komatsu, Yoshiaki Kuriu, Hisashi Ikoma, Takeshi Kubota, Masayoshi Nakanishi, Daisuke Ichikawa, Kazuma Okamoto, Chouhei Sakakura, Eigo Otsuji] Free jejunal transfer (FJT) has become one of the standard techniques used for reconstruction after total pharyngolaryngocervical esophagectomy (TPLCe); however, there are increasing concerns regarding the incidence of secondary esophageal cancer (EC) in these patients. We performed esophagectomy with gastric tube reconstruction in patients with EC who had previously undergone TPLCe with FJT. Patient 1 was a 53-year-old woman who previously received definitive chemoradiotherapy (dCRT) for middle thoracic EC. She subsequently underwent TPLCe with FJT for hypopharyngeal cancer. However, the recurrence of EC was found in the middle thoracic esophagus. Patient 2 was a 64-year-old man who previously underwent TPLCe with FJT for hypopharyngeal cancer. He subsequently underwent endoscopic submucosal dissection and dCRT for thoracic EC. He was readmitted with severe esophageal stricture following dCRT. Salvage esophagectomy with lymphadenectomy were performed. Right thoracotomy was performed in patient 1, whereas a laparoscopic transhiatal approach was used without thoracotomy in patient 2. After dissection of the thoracic esophagus, a cervical incision was made on the opposite side of the supplying vessels of the free jejunal flap (FJF) in both patients. The FJF was detected and its distal side was carefully exposed without damaging its supplying vessels or those of the permanent tracheal stoma. A gastric tube was pulled up via a posterior mediastinal route, and an anastomosis was made between the FJF and gastric tube. Postoperative recovery was uneventful in patient 1. Although minor anastomotic leakage was found in patient 2, it healed immediately with drainage treatment. The surgical approach for these patients must be chosen carefully in order to preserve the FJF, permanent tracheal stoma, and their blood supplies. The Japan Esophageal Society and Springer Japan, 2014 Gastric tube reconstruction nationallicence Free jejunal transfer nationallicence Esophageal cancer nationallicence Shiozaki Atsushi Division of Digestive Surgery, Department of Surgery, Kyoto Prefectural University of Medicine, 465 Kajii-cho, Kamigyo-ku, 602-8566, Kyoto, Japan aut Fujiwara Hitoshi Division of Digestive Surgery, Department of Surgery, Kyoto Prefectural University of Medicine, 465 Kajii-cho, Kamigyo-ku, 602-8566, Kyoto, Japan aut Konishi Hirotaka Division of Digestive Surgery, Department of Surgery, Kyoto Prefectural University of Medicine, 465 Kajii-cho, Kamigyo-ku, 602-8566, Kyoto, Japan aut Ishimoto Takeshi Division of Digestive Surgery, Department of Surgery, Kyoto Prefectural University of Medicine, 465 Kajii-cho, Kamigyo-ku, 602-8566, Kyoto, Japan aut Morimura Ryo Division of Digestive Surgery, Department of Surgery, Kyoto Prefectural University of Medicine, 465 Kajii-cho, Kamigyo-ku, 602-8566, Kyoto, Japan aut Murayama Yasutoshi Division of Digestive Surgery, Department of Surgery, Kyoto Prefectural University of Medicine, 465 Kajii-cho, Kamigyo-ku, 602-8566, Kyoto, Japan aut Komatsu Shuhei Division of Digestive Surgery, Department of Surgery, Kyoto Prefectural University of Medicine, 465 Kajii-cho, Kamigyo-ku, 602-8566, Kyoto, Japan aut Kuriu Yoshiaki Division of Digestive Surgery, Department of Surgery, Kyoto Prefectural University of Medicine, 465 Kajii-cho, Kamigyo-ku, 602-8566, Kyoto, Japan aut Ikoma Hisashi Division of Digestive Surgery, Department of Surgery, Kyoto Prefectural University of Medicine, 465 Kajii-cho, Kamigyo-ku, 602-8566, Kyoto, Japan aut Kubota Takeshi Division of Digestive Surgery, Department of Surgery, Kyoto Prefectural University of Medicine, 465 Kajii-cho, Kamigyo-ku, 602-8566, Kyoto, Japan aut Nakanishi Masayoshi Division of Digestive Surgery, Department of Surgery, Kyoto Prefectural University of Medicine, 465 Kajii-cho, Kamigyo-ku, 602-8566, Kyoto, Japan aut Ichikawa Daisuke Division of Digestive Surgery, Department of Surgery, Kyoto Prefectural University of Medicine, 465 Kajii-cho, Kamigyo-ku, 602-8566, Kyoto, Japan aut Okamoto Kazuma Division of Digestive Surgery, Department of Surgery, Kyoto Prefectural University of Medicine, 465 Kajii-cho, Kamigyo-ku, 602-8566, Kyoto, Japan aut Sakakura Chouhei Division of Digestive Surgery, Department of Surgery, Kyoto Prefectural University of Medicine, 465 Kajii-cho, Kamigyo-ku, 602-8566, Kyoto, Japan aut Otsuji Eigo Division of Digestive Surgery, Department of Surgery, Kyoto Prefectural University of Medicine, 465 Kajii-cho, Kamigyo-ku, 602-8566, Kyoto, Japan aut Esophagus Springer Japan 12/3(2015-07-01), 267-271 1612-9059 12:3<267 2015 12 10388 https://doi.org/10.1007/s10388-014-0426-8 text/html Onlinezugriff via DOI BK010053 XK010053 XK010000 Metadata rights reserved Springer special CC-BY-NC licence nationallicence 1 research-article jats NATIONALLICENCE NATIONALLICENCE NL-springer NATIONALLICENCE 856 40 https://doi.org/10.1007/s10388-014-0426-8 text/html Onlinezugriff via DOI NATIONALLICENCE 700 1- Shiozaki Atsushi Division of Digestive Surgery, Department of Surgery, Kyoto Prefectural University of Medicine, 465 Kajii-cho, Kamigyo-ku, 602-8566, Kyoto, Japan aut NATIONALLICENCE 700 1- Fujiwara Hitoshi Division of Digestive Surgery, Department of Surgery, Kyoto Prefectural University of Medicine, 465 Kajii-cho, Kamigyo-ku, 602-8566, Kyoto, Japan aut NATIONALLICENCE 700 1- Konishi Hirotaka Division of Digestive Surgery, Department of Surgery, Kyoto Prefectural University of Medicine, 465 Kajii-cho, Kamigyo-ku, 602-8566, Kyoto, Japan aut NATIONALLICENCE 700 1- Ishimoto Takeshi Division of Digestive Surgery, Department of Surgery, Kyoto Prefectural University of Medicine, 465 Kajii-cho, Kamigyo-ku, 602-8566, Kyoto, Japan aut NATIONALLICENCE 700 1- Morimura Ryo Division of Digestive Surgery, Department of Surgery, Kyoto Prefectural University of Medicine, 465 Kajii-cho, Kamigyo-ku, 602-8566, Kyoto, Japan aut NATIONALLICENCE 700 1- Murayama Yasutoshi Division of Digestive Surgery, Department of Surgery, Kyoto Prefectural University of Medicine, 465 Kajii-cho, Kamigyo-ku, 602-8566, Kyoto, Japan aut NATIONALLICENCE 700 1- Komatsu Shuhei Division of Digestive Surgery, Department of Surgery, Kyoto Prefectural University of Medicine, 465 Kajii-cho, Kamigyo-ku, 602-8566, Kyoto, Japan aut NATIONALLICENCE 700 1- Kuriu Yoshiaki Division of Digestive Surgery, Department of Surgery, Kyoto Prefectural University of Medicine, 465 Kajii-cho, Kamigyo-ku, 602-8566, Kyoto, Japan aut NATIONALLICENCE 700 1- Ikoma Hisashi Division of Digestive Surgery, Department of Surgery, Kyoto Prefectural University of Medicine, 465 Kajii-cho, Kamigyo-ku, 602-8566, Kyoto, Japan aut NATIONALLICENCE 700 1- Kubota Takeshi Division of Digestive Surgery, Department of Surgery, Kyoto Prefectural University of Medicine, 465 Kajii-cho, Kamigyo-ku, 602-8566, Kyoto, Japan aut NATIONALLICENCE 700 1- Nakanishi Masayoshi Division of Digestive Surgery, Department of Surgery, Kyoto Prefectural University of Medicine, 465 Kajii-cho, Kamigyo-ku, 602-8566, Kyoto, Japan aut NATIONALLICENCE 700 1- Ichikawa Daisuke Division of Digestive Surgery, Department of Surgery, Kyoto Prefectural University of Medicine, 465 Kajii-cho, Kamigyo-ku, 602-8566, Kyoto, Japan aut NATIONALLICENCE 700 1- Okamoto Kazuma Division of Digestive Surgery, Department of Surgery, Kyoto Prefectural University of Medicine, 465 Kajii-cho, Kamigyo-ku, 602-8566, Kyoto, Japan aut NATIONALLICENCE 700 1- Sakakura Chouhei Division of Digestive Surgery, Department of Surgery, Kyoto Prefectural University of Medicine, 465 Kajii-cho, Kamigyo-ku, 602-8566, Kyoto, Japan aut NATIONALLICENCE 700 1- Otsuji Eigo Division of Digestive Surgery, Department of Surgery, Kyoto Prefectural University of Medicine, 465 Kajii-cho, Kamigyo-ku, 602-8566, Kyoto, Japan aut NATIONALLICENCE 773 0- Esophagus Springer Japan 12/3(2015-07-01), 267-271 1612-9059 12:3<267 2015 12 10388