第8巻 2012年12月　第4号

■症例報告

化学放射線療法後の遺残食道癌に腹腔鏡補助下食道バイパス手術を施行した1例
松谷　毅¹, 野村　務¹, 萩原　信敏¹, 丸山　弘^1,2, 高尾　嘉宗^1,2, 内田　英二^1
1日本医科大学消化器外科学
²日本医科大学多摩永山病院外科

A Successfully Treated Case of Remnant Esophageal Cancer after Chemoradiotherapy by Laparoscopy Assisted Esophageal Bypass Operation
Takeshi Matsutani¹, Tsutomu Nomura¹, Nobutoshi Hagiwara¹, Hiroshi Maruyama^1,2, Yoshimune Takao^1,2 and Eiji Uchida^1
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.

日医大医会誌 2012; 8(4), 260-263

Key words
advanced esophageal cancer, chemoradiotherapy, laparoscopy assisted esophageal bypass operation

Correspondence to
Takeshi Matsutani, Department of Gastrointestinal Hepato-Biliary-Pancreatic Surgery, Nippon Medical School, 1-1-5 Sendagi, Bunkyo-ku Tokyo 113-8603, Japan
E-mail：matsutani@nms.ac.jp

受付：2012年6月7日　受理：2012年7月5日