Barrett’s adenocarcinoma arising 30 years after a Nissen fundoplication
Barrett’s adenocarcinoma arising 30 years after a Nissen fundoplication
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Nissen 胃底折叠术 30 年后出现 Barrett 腺癌
DOI：
10.1007/s10388-013-0370-z
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发表时间：
2013
期刊：
影响因子：
2.4
通讯作者：
Shimada Y
中科院分区：
文献类型：
--
作者：
Shimasaki T;Kawakami K;Minamoto T;et al;西尾禎治;Shimada Y
反流性食管炎的抗反流手术（ARS）被认为可以抑制Barrett上皮（BE）的进展，尽管ARS后仍有可能发生Barrett腺癌。在这里，我们涉及我们的经验，病人谁开发了巴雷特腺癌，尽管接受ARS。患者为60岁男性，30年前因反流性食管炎接受尼森胃底折叠术。内视镜检查发现在下胸段食道有一个突出的肿瘤。活检标本病理诊断为腺癌。我们进行了食管次全切除术和淋巴结清扫，并通过回结肠间置重建了食管。术后病理诊断为中分化腺癌，BE切片。6个淋巴结转移阳性。术后过程顺利。我们的病例表明，需要对很久以前接受过ARS的患者进行仔细监测。
Anti-reflux surgery (ARS) for reflux esophagitis is believed to inhibit the progression of Barrett’s epithelium (BE), although there is still a chance that Barrett’s adenocarcinoma will develop following ARS. Here, we relate our experience of a patient who developed a Barrett’s adenocarcinoma despite undergoing ARS. The patient was a 60-year-old male who underwent a Nissen fundoplication 30 years ago due to reflux esophagitis. Endoscopic examination revealed that there was a protruding tumor in the lower thoracic esophagus. The pathological diagnosis of the biopsied specimen was adenocarcinoma. We performed a subtotal esophagectomy with a lymph node dissection and reconstructed the esophagus with an ileocolic interposition. Postoperative pathological diagnosis showed moderately differentiated adenocarcinoma with a BE section. Six lymph nodes were positive for metastasis. The postoperative course was uneventful. Our case suggests that careful surveillance of patients who underwent ARS a long time ago is needed.