Management and Surgical Techniques for Gastric Tube Cancer
Summary
Gastric tube cancer develops in the gastric conduit used to reconstruct the alimentary tract after oesophagectomy and demands a tailored approach that balances oncological control with preservation of function. Early detection typically relies on routine endoscopic surveillance, with lesion characterisation via magnification endoscopy and endoscopic ultrasound. Superficial lesions may be treated by endoscopic submucosal dissection, whereas invasive tumours often require partial or total resection of the gastric tube. Surgical planning must account for altered anatomy and blood supply, principally conferred by the right gastroepiploic artery and its arcade. Techniques to assess perfusion, such as indocyanine green fluorescence imaging, guide decisions on the extent of resection and the need for vascular reconstruction. Reconstructive strategies follow resection: Roux-en-Y gastrojejunostomy or free jejunal graft interposition are used according to conduit length and route. Lymphadenectomy is customised to nodal risk, sometimes assisted by sentinel node biopsy to limit morbidity. Multidisciplinary management integrates nutritional support and postoperative rehabilitation, recognising the global rise in long-term survivors after cancer surgery and the consequent increased incidence of secondary gastric tube malignancy.
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Management and Surgical Techniques for Gastric Tube Cancer publication trend
The graph below shows the total number of articles in management and surgical techniques for gastric tube cancer across all publications each year (not limited to Nature Index journals).
Technical terms
Gastric tube cancer: Malignancy arising in the surgically formed gastric conduit after oesophagectomy.
Endoscopic submucosal dissection (ESD): A technique to remove early gastrointestinal neoplasms en bloc by dissecting beneath the submucosa.
Indocyanine green (ICG) fluorescence imaging: A method of visualising blood flow intraoperatively by intravenous dye and near-infrared light.
Sentinel node biopsy: Identification and pathological examination of the first draining lymph nodes to stage cancer and guide the extent of lymphadenectomy.
Right gastroepiploic artery: The principal arterial supply to a retrosternal or posterior mediastinal gastric conduit.
Roux-en-Y reconstruction: A technique to restore gastrointestinal continuity by fashioning a jejunal limb in Y configuration.
References
- Subtotal gastrectomy for gastric tube cancer using intraoperative indocyanine green fluorescence method. International Journal of Surgery Case Reports (2020).
- Successful preservation of the proximal stomach tube by evaluating blood flow using indocyanine green for gastric tube cancer: a case report. Surgical Case Reports (2020).
- Clinical Outcomes and Adverse Events of Endoscopic Submucosal Dissection for Gastric Tube Cancer after Esophagectomy. Gastroenterology Research and Practice (2019).
- Case report: Gastric tube cancer after esophagectomy—Retrograde perfusion after proximal resection of right gastroepiploic artery. International Journal of Surgery Case Reports (2019).
- Resection of distal gastric tube cancer with sentinel node biopsy: a case report and review of the literature. World Journal of Surgical Oncology (2015).
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