内容紹介
A Case of Thoracic Esophageal Cancer That Caused Necrosis of a Reconstructed Colon Ten Years after Esophagectomy
Summary
Necrosis of a reconstructed organ after esophageal cancer surgery is a very serious complication that often occurs soon after the surgery. We report a case of emergency surgery that was performed to treat necrosis of a reconstructed colon 10 years after esophagectomy. A 73-year-old man was admitted to our hospital with complaints of chest pain. His history included a proximal gastrectomy for gastric cancer. His present illness includes endoscopic mucosal resection for superficial esophageal cancer in 1995. Subtotal esophagectomy and right colon interposition through the retrosternal route were performed due to a recurrence in the same lesion in 2005. The patient was immediately hospitalized due to chest pain in 2015. An upper gastrointestinal endoscopy revealed extensive necrosis in the colon. He underwent an emergency operation. The surgical operations included reconstructed colonic resection by longitudinal sternotomy, esophagostomy, gastrostomy, and drainage procedure. The patient is currently under rehabilitation at a referral hospital. There has been no report on the occurrence of necrosis in the reconstructed colon 10 years after esophagectomy.
要旨
胸部食道癌術後の再建臓器壊死は非常に重篤な合併症で,術後早期に発生することが多い。今回,食道癌術後10年経過して再建結腸に壊死を来し,緊急手術を施行した1例を経験したので報告する。症例は73歳,男性。既往歴: 胃癌にて噴門側胃切除を施行した。現病歴: 1995年食道表在癌にてEMR,その後局所再発にて放射線化学療法を施行。2005年同部に再々発を認め,食道亜全摘術,胸骨後経路頸部食道残胃間右結腸間置術を施行した。2015年胸痛のため近医に緊急入院となった。上部消化管内視鏡検査で,再建結腸に広範囲な壊死を認め当科に転院となり緊急手術を施行した。術式は,胸骨縦切開による再建結腸切除,食道外瘻造設,胃瘻造設を施行した。病理検査: 出血性結腸壊死。現在,紹介医でリハビリテーション中である。食道癌手術10年後に再建臓器壊死を生じた報告はない。原因としては食餌性の結腸の拡張によるものなどが考えられる。
目次
Summary
Necrosis of a reconstructed organ after esophageal cancer surgery is a very serious complication that often occurs soon after the surgery. We report a case of emergency surgery that was performed to treat necrosis of a reconstructed colon 10 years after esophagectomy. A 73-year-old man was admitted to our hospital with complaints of chest pain. His history included a proximal gastrectomy for gastric cancer. His present illness includes endoscopic mucosal resection for superficial esophageal cancer in 1995. Subtotal esophagectomy and right colon interposition through the retrosternal route were performed due to a recurrence in the same lesion in 2005. The patient was immediately hospitalized due to chest pain in 2015. An upper gastrointestinal endoscopy revealed extensive necrosis in the colon. He underwent an emergency operation. The surgical operations included reconstructed colonic resection by longitudinal sternotomy, esophagostomy, gastrostomy, and drainage procedure. The patient is currently under rehabilitation at a referral hospital. There has been no report on the occurrence of necrosis in the reconstructed colon 10 years after esophagectomy.
要旨
胸部食道癌術後の再建臓器壊死は非常に重篤な合併症で,術後早期に発生することが多い。今回,食道癌術後10年経過して再建結腸に壊死を来し,緊急手術を施行した1例を経験したので報告する。症例は73歳,男性。既往歴: 胃癌にて噴門側胃切除を施行した。現病歴: 1995年食道表在癌にてEMR,その後局所再発にて放射線化学療法を施行。2005年同部に再々発を認め,食道亜全摘術,胸骨後経路頸部食道残胃間右結腸間置術を施行した。2015年胸痛のため近医に緊急入院となった。上部消化管内視鏡検査で,再建結腸に広範囲な壊死を認め当科に転院となり緊急手術を施行した。術式は,胸骨縦切開による再建結腸切除,食道外瘻造設,胃瘻造設を施行した。病理検査: 出血性結腸壊死。現在,紹介医でリハビリテーション中である。食道癌手術10年後に再建臓器壊死を生じた報告はない。原因としては食餌性の結腸の拡張によるものなどが考えられる。