Case Report Surgical treatment of synchronous early esophageal and gastric cancer: esophageal reconstruction with a retrograde gastric tube

A 51-year-old man with a 5 days history of mild dysphagia was referred to our hospital. Computed tomography of the chest and abdomen showed a bulge tumor of the lower third esophageal wall and a malignant lesion in the antrum in the distal part of the stomach. The patient underwent a left anterolateral thoracotomy through the sixth intercostal space via a ventral midline incision, with a two-field lymph node dissection of the upper abdomen and mediastinum. The proximal stomach was divided into two parts. One part was used for a gastroesophageal anastomosis, called a retrograde gastric tube. The other part was used for a gastrojejunal end-to-side anastomosis. The retrograde gastric tube was placed in the esophageal bed and the lesser curvature of the remnant stomach was in the abdominal cavity. The patient started a liquid diet on postoperative day 9 and was discharged on postoperative day 15. On follow-up one and a half years after surgery, the patient was in a good condition and there was no evidence of recurrence or metastases. In this report, we demonstrate that a retrograde gastric tube can be used for reconstruction in patients with synchronous early low esophageal and distal gastric cancer.