Heterochronous Suture Line Recurrences in the Jejunal Pouch following Total Gastrectomy for Stage II Gastric Cancer: A Case Report and Literature Review
Open Access
- 19 March 2020
- journal article
- review article
- Published by S. Karger AG in Case Reports in Oncology
- Vol. 13 (1), 225-232
- https://doi.org/10.1159/000505392
Abstract
We report the case of a 65-year-old male who developed heterochronous local recurrences of gastric cancer in the jejunal pouch (J-pouch) four times after total gastrectomy. He underwent total gastrectomy, J-pouch, and Roux-en-Y reconstruction for stage II gastric cancer in 2005. Four local recurrences appeared on the esophago-jejunal anastomosis, the suture line within the pouch, the esophago-jejunal anastomosis, and the anastomosis between the jejunum and Y-loop, which were resected by partial excision or endoscopic submucosal dissection. Suture line recurrence of gastric cancer is rare. The common features for each recurrence included the surgically negative resection margins, observation of the same histopathological subtype, absence of remote metastasis or peritoneal seeding, and the recurrence on the anastomotic suture line, suggesting that the cause of recurrence was the implantation of exfoliated cancer cells probably in the suture line. However, there is no established procedure for preventing implantation recurrence currently, the effectiveness of lumen lavage is suggested.Keywords
This publication has 9 references indexed in Scilit:
- Pouch vs. No Pouch Following Total Gastrectomy: Meta-Analysis and Systematic ReviewThe American Journal of Gastroenterology, 2009
- Suture-line recurrence at a jejunojejunal anastomosis after gastrectomy for gastric cancerGastric Cancer, 2008
- Recurrence of gastric cancer in the jejunal pouch after completion gastrectomyGastric Cancer, 2007
- Suture line recurrence in the jejunal pouch after curative proximal gastrectomy for gastric cancer: report of two cases.2007
- A CASE OF SUCCESSFULLY RESECTED STOMAL RECURRENCE OF GASTRIC CANCER DEVELOPED 13-YEARS AFTER TOTAL GASTRECTOMYNihon Rinsho Geka Gakkai Zasshi (Journal of Japan Surgical Association), 2004
- Recurrence in jejunal pouch after proximal gastrectomy for early upper gastric cancerGastric Cancer, 2003
- Long-term effects of jejunal pouch added to Roux-en-Y reconstruction after total gastrectomyGastric Cancer, 2001
- Suture line recurrence in jejunal pouch replaced after total gastrectomy for gastric cancerGastric Cancer, 1999
- Anastomotic recurrence in the oesophagus complicating gastrectomy for adenocarcinoma of the stomachBritish Journal of Surgery, 1979