Nakayama esophagoduodenostomy as a reconstructive stage after gastrectomy for gastric cancer complicated by acute bleeding and Krukenberg metastases. Clinical case
Keywords:stomach cancer, bleeding, gastrectomy, esophagoduodenoanastomosis
Purpose - on a clinical case to justify the technical aspects of applying the Nakayama esophago-duodenostomy as a reconstructive stage after gastrectomy for gastric cancer complicated by acute bleeding and Krukenberg metastases.
Clinical case. Patient O., born in 1975, was being treated for stomach cancer complicated by moderate acute bleeding and Krukenberg metastases in the surgery department No. 3 of the Kyiv City Emergency Clinical Hospital. The patient general clinical, special laboratory and instrumental research methods were carried out (electrocardiography, esophagogastroduodenoscopy, ultrasound examination of the organs of the abdominal cavity and small pelvis, computer tomography of the organs of the abdominal cavity and small pelvis with intravenous contrast).
The patient had cancer of the cardiac part of the stomach, complicated by moderate gastrointestinal bleeding with the presence of Krukenberg metastases, in connection with which the patient underwent surgery in the early delayed period according to a unique method - gastrectomy with lymphodissection in the volume of D2+ and overlapping esophageal-duodenal anastomosis according to the Nakayama type in the modification of the clinic. The patient was discharged in a satisfactory condition on the 10th day after surgery under the supervision of an oncologist and a surgeon at her place of residence. During the dynamic observation for 12 months, she felt satisfactory.
Conclusions. Using the example of a clinical case, the technical aspects of applying the Nakayama esophagoduodenostomy as a reconstructive stage after gastrectomy for gastric cancer complicated by acute bleeding and Krukenberg metastases are substantiated.
The research was carried out in accordance with the principles of the Helsinki Declaration. The informed consent of the patient was obtained for conducting the studies.
No conflict of interests was declared by the authors.
Chen S, Li YF, Feng XY et al. (2012, Dec). Significance of palliative gastrectomy for late-stage gastric cancer patients. J Surg Oncol. 106 (7): 862-71. https://doi.org/10.1002/jso.23158; PMid:22648960
Choi YY, Noh SH, Cheong JH. (2015, Sep). Evolution of gastric cancer treatment: from the golden age of surgery to an era of precision medicine. Yonsei Med J. 56 (5): 1177-1185. https://doi.org/10.3349/ymj.2015.56.5.1177; PMid:26256958 PMCid:PMC4541645
Cowling J, Gorman B, Riaz A, Bundred JR, Kamarajah SK, Evans RPT et al. (2021). Peri-operative outcomes and survival following palliative gastrectomy for gastric cancer: a systematic review and meta-analysis. J Gastrointest Cancer. 52 (1): 41-56. https://doi.org/10.1007/s12029-020-00519-4; PMid:32959118 PMCid:PMC7900337
Fedorenko ZP, Hulak LO, Mykhailovych YuI ta in. (2021). Rak v Ukraini, 2019-2020. Zakhvoriuvanist, smertnist, pokaznyky diialnosti onkolohichnoi sluzhby, Biul. nats. kantser-reiestru Ukrainy. 22: 123.
Li J. (2020, Mar 2). Gastric cancer in young adults: A different clinical entity from carcinogenesis to prognosis. gastroenterol Res Pract: 9512707. https://doi.org/10.1155/2020/9512707; PMid:32190044 PMCid:PMC7071806
Marano L, Polom K, Patriti A et al. (2016, Jan). Surgical management of advanced gastric cancer: An evolving issue. Eur J Surg Oncol. 42 (1): 18-27. https://doi.org/10.1016/j.ejso.2015.10.016; PMid:26632080
Price TJ, Shapiro JD, Segelov E et al. (2012, Apr). Management of advanced gastric cancer. Expert Rev Gastroenterol Hepatol. 6 (2): 199-208; quiz 209. https://doi.org/10.1586/egh.11.103; PMid:22375525
Shiozaki H, Shimodaira Y, Elimova E, Wadhwa R, Sudo K, Harada K et al. (2016). Evolution of gastric surgery techniques and outcomes. Chin J Cancer. 35 (1): 69. https://doi.org/10.1186/s40880-016-0134-y; PMid:27460019 PMCid:PMC4962398
Thakur B, Devkota M, Sharma A. (2019, Aug 4). Evidence based surgical approach to locally advanced gastric cancer. J Nepal Health Res Counc. 17 (2): 133-140. https://doi.org/10.33314/jnhrc.v0i0.2055; PMid:31455923
Wang SY, Hsu CH, Liao CH, Fu CY, Ouyang CH, Cheng CT et al. (2017). Surgical outcome evaluation of perforated gastric cancer: from the aspects of both acute care surgery and surgical oncology. Scand J Gastroenterol. 52 (12): 1371-1376. https://doi.org/10.1080/00365521.2017.1369562; PMid:28838270
Yuldoshev RZ. (2010). Khyrurhycheskoe lechenye nekotorikh oslozhnennikh y rasprostranennikh form raka zheludka. Avtoreferat dyssertatsyy. Byshkek: Kirhizsko-ros. slavian. un-t: 45.
Copyright (c) 2023 Paediatric Surgery (Ukraine)
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
The policy of the Journal “PAEDIATRIC SURGERY. UKRAINE” is compatible with the vast majority of funders' of open access and self-archiving policies. The journal provides immediate open access route being convinced that everyone – not only scientists - can benefit from research results, and publishes articles exclusively under open access distribution, with a Creative Commons Attribution-Noncommercial 4.0 international license(СС BY-NC).
Authors transfer the copyright to the Journal “PAEDIATRIC SURGERY.UKRAINE” when the manuscript is accepted for publication. Authors declare that this manuscript has not been published nor is under simultaneous consideration for publication elsewhere. After publication, the articles become freely available on-line to the public.
Readers have the right to use, distribute, and reproduce articles in any medium, provided the articles and the journal are properly cited.
The use of published materials for commercial purposes is strongly prohibited.