Abstract
A 68-year-old man was diagnosed with local recurrent cancer of the ampulla of Vater by follow-up endoscopy 3 years after an endoscopic papillectomy. A screening endoscopy found superficial middle thoracic esophageal cancer. The patient required an esophagectomy and pancreatoduodenectomy. We chose a two-stage operation for the esophageal cancer and the local recurrent cancer of the ampulla of Vater, both to reduce surgical invasiveness and to circumvent the lower curability. The first-stage operation consisted of a right transthoracic subtotal esophagectomy with mediastinal and cervical lymph node dissection, external esophagostomy of the neck, and gastrostomy. Forty days after the first surgery, a gastroduodenal artery- and right gastroepiploic vessel-preserving pancreatoduodenectomy with Child’s reconstruction was performed as the second-stage surgery. Esophageal reconstruction was achieved using a gastric tube via the percutaneous route with vascular anastomosis.
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References
Kato H, Watanabe H, Tachimori Y, Iizuka T. Evaluation of neck lymph node dissection for thoracic esophageal carcinoma. Ann Thorac Surg. 1991;51:931–5.
Bassi C, Dervenis C, Butturini G, Fingerhut A, Yeo C, Izbicki J, et al. Postoperative pancreatic fistula: an international study group (ISGPF) definition. Surgery. 2005;138(1):8–13.
Mafune K, Tanaka Y, Ma YY, Takubo K. Synchronous cancers of the esophagus and the ampulla of Vater after distal gastrectomy: successful removal of the esophagus, gastric remnant, duodenum, and pancreatic head. J Surg Oncol. 1995;60(4):277–81.
Kurosaki I, Hatakeyama K, Nihei K, Suzuki T, Tsukada K. Thoracic esophagectomy combined with pylorus-preserving pancreatoduodenectomy in a one-stage procedure: report of a case. Surg Today. 2000;30:168–72.
Kim JY, Hanasono MM, Fleming JB, Berry MD, Hofstetter WL. Combined esophagectomy and pancreaticoduodenectomy: expanded indication for supercharged jejunal interposition. J Gastrointest Surg. 2011;15:1893–5.
Motoyama S, Yamamoto Y, Maruyama K, Uchinami H, Hasegawa M, Shindo Y, et al. A new two-stage esophagectomy followed by pancreaticoduodenectomy. Am Surg. 2010;76:1442–4.
Gyorki DE, Clarke NE, Hii MW, Banting SW, Cade RJ. Management of synchronous tumors of the oesophagus and pancreatic head: a novel approach. Ann R Coll Surg Engl. 2011;93:e111–3.
Yasuda T, Shiozaki H. Esophageal reconstruction with colon tissue. Surg Today. 2011;41:745–53.
Sugimachi K, Kitamura M, Maekawa S, Matsufuji H, Kai H, Okudaia Y. Two-stage operation for poor-risk patients with carcinoma of the esophagus. J Surg Oncol. 1987;36:105–9.
Saito K, Shimoda K, Shigemitsu Y, Kinoshita T, Miyahara M, Kobayashi M. Extensive lymphadenectomy for thoracic esophageal carcinoma: a two-stage operation for high-risk patients. Surg Today. 1994;24:610–5.
Branum GD, Pappas TN, Meyers WC. The management of tumors of the ampulla of Vater by local resection. Ann Surg. 1996;224:621–7.
Beger HG, Treitschke F, Gansauge F, Harada N, Hiki N, Mattfeldt T. Tumor of the ampulla of Vater: experience with local or radical resection in 171 consecutively treated patients. Arch Surg. 1999;134:526–32.
Sata N, Koizumi M, Kaneda Y, Ishiguro Y, Kurogochi A, Endo K, et al. Extraduodenal papillectomy: a feasible alternative method of total papillectomy. J Gastrointest Surg. 2014;18:858–64.
Ito K, Fujita N, Noda Y, Kobayashi G, Obana T, Horaguchi J, et al. Impact of technical modification of endoscopic papillectomy for ampullary neoplasm on the occurrence of complications. Dig Endosc. 2012;24:30–5.
Napoleon B, Gincul R, Ponchon T, Berthiller J, Escourrou J, Canard JM, Sociéte Française d’Endoscopie Digestive (SFED, French Society of Digestive Endoscopy), et al. Endoscopic papillectomy for early ampullary tumors: long-term results from a large multicenter prospective study. Endoscopy. 2014;46:127–34.
Tsuji S, Itoi T, Sofuni A, Mukai S, Tonozuka R, Moriyasu F. Tips and tricks in endoscopic papillectomy of ampullary tumors: single-center experience with large case series (with videos). J Hepatobiliary Pancreat Sci. 2015;22:E22–7.
Kato H, Sato A, Fukuda H, Kagami Y, Udagawa H, Togo A, et al. A phase II trial of chemoradiotherapy for stage I esophageal squamous cell carcinoma: Japan Clinical Oncology Group Study (JCOG9708). Jpn J Clin Oncol. 2009;39:638–43.
Yoon YS, Kim SW, Park SJ, Lee HS, Jang JY, Choi MG, et al. Clinicopathologic analysis of early ampullary cancers with a focus on the feasibility of ampullectomy. Ann Surg. 2005;242:92–100.
Woo SM, Ryu JK, Lee SH, Lee WJ, Hwang JH, Yoo JW, et al. Feasibility of endoscopic papillectomy in early stage ampulla of Vater cancer. J Gastroenterol Hepatol. 2009;24:120–4.
Roggin KK, Yeh JJ, Ferrone CR, Riedel E, Gerdes H, Klimstra DS, Jaques DP, Brennan MF. Limitations of ampullectomy in the treatment of nonfamilial ampullary neoplasms. Ann Surg Oncol. 2005;12:971–80.
Ishihara Ryu, Ishii Hiroyasu. Magnifying endoscopic diagnosis of superficial esophageal cancer introduction and explanation of the Japan esophageal society classification. Gastroenterol Endosc. 2014;56:3818–26.
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Fukaya, M., Nishio, H., Kobayashi, S. et al. Synchronous double primary cancer of the esophagus and ampulla of Vater successfully treated by a two-stage operation: report of a case. Esophagus 13, 295–300 (2016). https://doi.org/10.1007/s10388-015-0509-1
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DOI: https://doi.org/10.1007/s10388-015-0509-1