Metachronous cancer of gastroplasty after esophagectomy

The incidence of gastric tube cancer after esophagectomy has increasedrecently with prolongation of survival of patient with esophagealcancer. It may be found in 0,2 to 3,5% of patients treatedfor esophageal carcinomas. In our experience, we observed 2 casesof gastric tube carcinomas among 750 cases who had surgical resectionfor esophageal cancer by Ivor Lewis procedure from 1980 to2005 (0,2%). In the first case, the cancer was detected during thefollow-up by endoscopic examination. Total resection of gastrictube and reconstruction by Roux-en-Y were performed. The patientis alive and disease free one year after surgery. In the second case,the gastric tumor was revealed by thoracic pain. Chemotherapy,using Carboplatin-5Fluoro-Uracil, was performed because of lungmetastasis. Patient died of disease one year later.The clinical symptoms related to tumors are associated with shorttermsurvival, whereas the cancers detected by periodic endoscopyscreening have occasional long-term survival. Total gastrectomy isproposed for surgical treatment but the operating procedure is complicatedand invasive. Early single location and mucosal cancer canbe treated by endoscopic mucosal resection. A majority of reportsexperienced good results with this technique.Early diagnosis, by annual endoscopic examination, permits bestresults in the treatment of metachronous gastric carcinoma arisingfrom gastric tubes used for reconstruction after oesophagectomy