A Successfully Treated Case of Remnant Esophageal Cancer after Chemoradiotherapy by Laparoscopy Assisted Esophageal Bypass Operation
1)Department of Gastrointestinal Hepato-Biliary-Pancreatic Surgery, Nippon Medical School
2)Department of Surgery, Nippon Medical School Tama Nagayama Hospital
A 70-year-old male with a chief complaint of dysphagia was admitted to our hospital. Upper gastrointestinal endoscopy revealed an advanced tumor at the middle and lower third of the esophagus, and pathological examination of the biopsy specimens revealed a moderately-differentiated squamous cell carcinoma. Computed tomography of the chest showed cT3N1M0, cStage III. The patient rejected radical esophagectomy, and received definitive chemoradiotherapy (CRT) with docetaxel, nedaplatin and 5-FU. Follow-up examinations after CRT evaluated a partial response. However, an endoscope could not pass through the stricture in the esophagus. The patient underwent single-port gastrostomy to improve nutritional status and hypoproteinemia. On 5 months after CRT, the patient has improved nutritional condition, and laparoscopy assisted esophageal bypass operation was performed. Postoperatively, the patient was able to eat most foods for 9 months. The patient died by the carcinomatosis 10 months after bypass operation.
ϊγεγο 2012; 8(4), 260-263
advanced esophageal cancer, chemoradiotherapy, laparoscopy assisted esophageal bypass operation
Takeshi Matsutani, Department of Gastrointestinal Hepato-Biliary-Pancreatic Surgery, Nippon Medical School, 1-1-5 Sendagi, Bunkyo-ku Tokyo 113-8603, Japan