食道癌術後早期に気管胃管瘻を合併した1例

The patient was a４５-year-old man. He had suffered from nephrotic syndrome at time of his twenties and had steroid salvage treatment. But he retired the treatment by himself. Esophageal tumor was suspected at the screening, and he was referred to our hospital.
Preoperative diagnosis was the adenocarcinoma of the esophagogastric junction（cT２N０M０ stage Ⅱ）．
Thoracoscopy assisted subtotal esophagectomy in prone position with D２dissection was performed. Gastric role was prepared in laparoscopic approach, and pulled up to the neck via posterior mediastinal route. Although early postoperative course was uneventful and esophageal fluoroscopy on the７th day showed no leakage, sudden dyspnea appeared on the８th day. CT examination and Bronchoscopy showed tracheoesophageal fistula. Unfortunately, the fistula didn’t get well, and we considered that it was difficult to close the fistula by only conservative treatment.
Esophageal covered stent was inserted on the５６th day. After that, he could start ingestion intake and was discharged from hospital on the８５th day. Now, he is being followed up in our hospital.

四国医学雑誌 : http://www.tokushima-u.ac.jp/med/research/shikoku_acta_medica.html