食道癌に対する胸骨後経路胃管再建術後の冠動脈バイパス術併施大動脈弁置換術の1例
食道癌術後の胸骨後経路胃管を有した冠動脈1枝病変および大動脈弁狭窄症に対して冠動脈バイパス術併施大動脈弁置換術を施行した．症例は80歳男性で，食道癌に対する胸骨後経路胃管再建による根治術の既往を有していた．下腿浮腫出現のため精査を行ったところ，冠動脈1枝病変および大動脈弁狭窄症と診断され，手術適応との判断より当科を紹介された．手術は上腹部小開腹で胃管を同定し，胸骨裏面から胃管を慎重に剥離し胸骨正中切開した．胸骨左側とともに胃管を左側に展開し良好な視野でCABG1枝バイパス（Ao-SVG-RCA#4PD）およびAVR（MAGNA 21 mm）を施行した．術後，呼吸循環の回復に時間を要し尿路感染症...
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| Published in | 日本心臓血管外科学会雑誌 Vol. 43; no. 2; pp. 67 - 71 |
|---|---|
| Main Authors | , , , , |
| Format | Journal Article |
| Language | Japanese |
| Published |
特定非営利活動法人 日本心臓血管外科学会
2014
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| Subjects | |
| Online Access | Get full text |
| ISSN | 0285-1474 1883-4108 |
| DOI | 10.4326/jjcvs.43.67 |
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| Abstract | 食道癌術後の胸骨後経路胃管を有した冠動脈1枝病変および大動脈弁狭窄症に対して冠動脈バイパス術併施大動脈弁置換術を施行した．症例は80歳男性で，食道癌に対する胸骨後経路胃管再建による根治術の既往を有していた．下腿浮腫出現のため精査を行ったところ，冠動脈1枝病変および大動脈弁狭窄症と診断され，手術適応との判断より当科を紹介された．手術は上腹部小開腹で胃管を同定し，胸骨裏面から胃管を慎重に剥離し胸骨正中切開した．胸骨左側とともに胃管を左側に展開し良好な視野でCABG1枝バイパス（Ao-SVG-RCA#4PD）およびAVR（MAGNA 21 mm）を施行した．術後，呼吸循環の回復に時間を要し尿路感染症を併発したが軽快し第40病日に退院した．食道癌に対する根治術後胸骨後経路再建導管を有する症例における心臓手術ではアプローチ法に工夫を要するが，今回われわれは胸骨正中切開アプローチで手術を行い良好な結果であった． |
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| AbstractList | 食道癌術後の胸骨後経路胃管を有した冠動脈1枝病変および大動脈弁狭窄症に対して冠動脈バイパス術併施大動脈弁置換術を施行した．症例は80歳男性で，食道癌に対する胸骨後経路胃管再建による根治術の既往を有していた．下腿浮腫出現のため精査を行ったところ，冠動脈1枝病変および大動脈弁狭窄症と診断され，手術適応との判断より当科を紹介された．手術は上腹部小開腹で胃管を同定し，胸骨裏面から胃管を慎重に剥離し胸骨正中切開した．胸骨左側とともに胃管を左側に展開し良好な視野でCABG1枝バイパス（Ao-SVG-RCA#4PD）およびAVR（MAGNA 21 mm）を施行した．術後，呼吸循環の回復に時間を要し尿路感染症を併発したが軽快し第40病日に退院した．食道癌に対する根治術後胸骨後経路再建導管を有する症例における心臓手術ではアプローチ法に工夫を要するが，今回われわれは胸骨正中切開アプローチで手術を行い良好な結果であった． |
| Author | 盛島, 裕次 山里, 隆浩 久貝, 忠男 摩文仁, 克人 阿部, 陛之 |
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| References | 17) Kuwano, H., Amano, J., Yokomise, H. et al. : Thoracic and cardiovascular surgery in Japan during 2010. Gen. Thorac. Cardiovasc. Surg. 60 : 680-708, 2012. 20) Fujii, G., Ito, T., Maekawa, A. et al. : Minimally invasive approach (para-sternum small incision) for aortic valve replacement. Jpn. J. Cardiovasc. Surg. 42 : 11-15, 2013. 9) Iida, T., Nishimori, H., Fukutomi, T. et al. : Aortic valve replacement after retrosternal gastric tube reconstruction for esophageal cancer. Jpn. J. Cardiovasc. Surg. 37 : 329-332, 2008. 15) Hara, M., Fujii, T., Shiono, N. et al. : Aortic valve replacement after retrosternal gastric tube reconstruction for esophageal cancer—a case report—. J. Jpn. Surg. Assoc. 72 : 627-629, 2011. 2) Francesca, S.L., Ruvolo, G., Greco, E. et al. : Left thoracotomy for coronary revascularization. Tex. Heart Inst. J. 22 : 200-201, 1995. 12) Takami, H., Doki, Y., Yachiku, K. et al. : Aortic valve replacement for a patient with porcelain aorta and retrosternal gastric tube reconstruction after esophageal resection. Jpn. J. Thorac. Cardiovasc. Surg. 51 : 685-687, 2003. 18) Makuuchi, H., Shimada, H., Chino, O. et al. : Outcome of the treatment for esophageal cancer. Shokaki Geka 32 : 552-557, 2009. 6) Kato, Y., Miyamoto, S., Minamimura, H. et al. : A case of coronary artery bypass grafting through the left thoracotomy after substernal gastric interposition for carcinoma of the esophagus. Jpn. J. Cardiovasc. Surg. 32 : 276-279, 2003. 19) Cosgrove, D.M. and Sabik, J.F. : Minimally invasive approach for aortic valve operation. Ann. Thorac. Surg. 62 : 596-597, 1996. 4) Hirose, H., Amano, A., Yoshida, S. et al. : Coronary artery bypass graft after esophagogastrectomy. Eur. J. Cardio-thorac. Surg. 15 : 729-731, 1999. 7) Kawase, Y. and Watanabe, G. : Anterolateral right thoracotomy for mitral valve replacement for treating infectious endocarditis in a case with esophagus reconstruction by presternal colonic interposition for previous esophagogastrectomy. Jpn. J. Cardiovasc. Surg. 37 : 291-294, 2008. 13) Tobinaga, S., Tayama, K., Kawano, H. et al. : Aortic valve replacement after esophagectomy with substernal gastric tube reconstruction. Ann. Thorac. Cardiovasc. Surg. 12 : 213-215, 2006. 1) Safi, H.J., Barnett, M.G. and Turner, W. : Coronary artery bypass after substernal colon interposition for carcinoma of the esophagus. Cardiovasc. Surg. 2 : 415-417, 1994. 3) Takahara, Y., Sudo, Y. and Nakazima, N. : Aortic valve replacement via left thoracotomy after an esophageal operation. Ann. Thorac. Surg. 63 : 225-227, 1997. 10) Kanemitsu, N., Aota, M., Nakane, T. et al. : Mitral valve replacement for mitral regurgitation with annular carcification after esophageal resection and retrosternal gastric tube reconstruction. Jpn. J. Cardiovasc. Surg. 39 : 216-219, 2010. 14) Fukui, S., Mitsuno, M., Yamamura, M. et al. : Aortic valve replacement in a patient with a retrosternal gastric tube and porcelain aorta. Ann. Thorac. Cardiovasc. Surg. 15 : 343-345, 2009. 8) Gillinov, A.M., Casselman, F.P. and Cosgrove, D.M. : Aortic valve replacement after substernal colon interposition. Ann. Thorac. Surg. 67 : 838-839, 1999. 16) Kitagawa, Y. : Therapeutic strategies for advanced respectable esophageal cancer. J. Jpn. Surg. Soc. 109 : 333-337, 2008. 22) Smith, C.R., Leon, M.B., Mack, M.J. et al. : Transcatheter versus surgical aortic-valve replacement in high-risk patients. N. Engl. J. Med. 364 : 2187-2198, 2011. 23) Kanimura, S., Kuratani, T., Shimamura, K. et al. : Transcatheter aortic valve implantation : first trans-iliac experience in Japan. Gen. Thorac. Cardiovasc. Surg. 59 : 273-276, 2011. 21) Cribier, A., Eltchaninoff, H., Bash, A. et al. : Percutaneous transcatheter implantation of an aortic valve prosthesis for calcific aortic stenosis : first human case description. Circulation 106 : 3006-3008, 2002. 5) Iemura, J., Oku, H., Ohtaki, M. et al. : Coronary artery bypass grafting following substernal gastric interposition. Jpn. Circ. J. 64 : 404-405, 2000. 11) Matsuda, H., Okada, M., Yamashita, C. et al. : Aortic valve replacement after retrosternal gastric tube reconstruction for esophageal cancer. Jpn. J. Thorac. Cardiovasc. Surg. 47 : 234-236, 1999. |
| References_xml | – reference: 5) Iemura, J., Oku, H., Ohtaki, M. et al. : Coronary artery bypass grafting following substernal gastric interposition. Jpn. Circ. J. 64 : 404-405, 2000. – reference: 10) Kanemitsu, N., Aota, M., Nakane, T. et al. : Mitral valve replacement for mitral regurgitation with annular carcification after esophageal resection and retrosternal gastric tube reconstruction. Jpn. J. Cardiovasc. Surg. 39 : 216-219, 2010. – reference: 4) Hirose, H., Amano, A., Yoshida, S. et al. : Coronary artery bypass graft after esophagogastrectomy. Eur. J. Cardio-thorac. Surg. 15 : 729-731, 1999. – reference: 20) Fujii, G., Ito, T., Maekawa, A. et al. : Minimally invasive approach (para-sternum small incision) for aortic valve replacement. Jpn. J. Cardiovasc. Surg. 42 : 11-15, 2013. – reference: 23) Kanimura, S., Kuratani, T., Shimamura, K. et al. : Transcatheter aortic valve implantation : first trans-iliac experience in Japan. Gen. Thorac. Cardiovasc. Surg. 59 : 273-276, 2011. – reference: 13) Tobinaga, S., Tayama, K., Kawano, H. et al. : Aortic valve replacement after esophagectomy with substernal gastric tube reconstruction. Ann. Thorac. Cardiovasc. Surg. 12 : 213-215, 2006. – reference: 19) Cosgrove, D.M. and Sabik, J.F. : Minimally invasive approach for aortic valve operation. Ann. Thorac. Surg. 62 : 596-597, 1996. – reference: 6) Kato, Y., Miyamoto, S., Minamimura, H. et al. : A case of coronary artery bypass grafting through the left thoracotomy after substernal gastric interposition for carcinoma of the esophagus. Jpn. J. Cardiovasc. Surg. 32 : 276-279, 2003. – reference: 16) Kitagawa, Y. : Therapeutic strategies for advanced respectable esophageal cancer. J. Jpn. Surg. Soc. 109 : 333-337, 2008. – reference: 1) Safi, H.J., Barnett, M.G. and Turner, W. : Coronary artery bypass after substernal colon interposition for carcinoma of the esophagus. Cardiovasc. Surg. 2 : 415-417, 1994. – reference: 2) Francesca, S.L., Ruvolo, G., Greco, E. et al. : Left thoracotomy for coronary revascularization. Tex. Heart Inst. J. 22 : 200-201, 1995. – reference: 7) Kawase, Y. and Watanabe, G. : Anterolateral right thoracotomy for mitral valve replacement for treating infectious endocarditis in a case with esophagus reconstruction by presternal colonic interposition for previous esophagogastrectomy. Jpn. J. Cardiovasc. Surg. 37 : 291-294, 2008. – reference: 18) Makuuchi, H., Shimada, H., Chino, O. et al. : Outcome of the treatment for esophageal cancer. Shokaki Geka 32 : 552-557, 2009. – reference: 3) Takahara, Y., Sudo, Y. and Nakazima, N. : Aortic valve replacement via left thoracotomy after an esophageal operation. Ann. Thorac. Surg. 63 : 225-227, 1997. – reference: 15) Hara, M., Fujii, T., Shiono, N. et al. : Aortic valve replacement after retrosternal gastric tube reconstruction for esophageal cancer—a case report—. J. Jpn. Surg. Assoc. 72 : 627-629, 2011. – reference: 12) Takami, H., Doki, Y., Yachiku, K. et al. : Aortic valve replacement for a patient with porcelain aorta and retrosternal gastric tube reconstruction after esophageal resection. Jpn. J. Thorac. Cardiovasc. Surg. 51 : 685-687, 2003. – reference: 17) Kuwano, H., Amano, J., Yokomise, H. et al. : Thoracic and cardiovascular surgery in Japan during 2010. Gen. Thorac. Cardiovasc. Surg. 60 : 680-708, 2012. – reference: 9) Iida, T., Nishimori, H., Fukutomi, T. et al. : Aortic valve replacement after retrosternal gastric tube reconstruction for esophageal cancer. Jpn. J. Cardiovasc. Surg. 37 : 329-332, 2008. – reference: 21) Cribier, A., Eltchaninoff, H., Bash, A. et al. : Percutaneous transcatheter implantation of an aortic valve prosthesis for calcific aortic stenosis : first human case description. Circulation 106 : 3006-3008, 2002. – reference: 22) Smith, C.R., Leon, M.B., Mack, M.J. et al. : Transcatheter versus surgical aortic-valve replacement in high-risk patients. N. Engl. J. Med. 364 : 2187-2198, 2011. – reference: 11) Matsuda, H., Okada, M., Yamashita, C. et al. : Aortic valve replacement after retrosternal gastric tube reconstruction for esophageal cancer. Jpn. J. Thorac. Cardiovasc. Surg. 47 : 234-236, 1999. – reference: 14) Fukui, S., Mitsuno, M., Yamamura, M. et al. : Aortic valve replacement in a patient with a retrosternal gastric tube and porcelain aorta. Ann. Thorac. Cardiovasc. Surg. 15 : 343-345, 2009. – reference: 8) Gillinov, A.M., Casselman, F.P. and Cosgrove, D.M. : Aortic valve replacement after substernal colon interposition. Ann. Thorac. Surg. 67 : 838-839, 1999. |
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| Snippet | 食道癌術後の胸骨後経路胃管を有した冠動脈1枝病変および大動脈弁狭窄症に対して冠動脈バイパス術併施大動脈弁置換術を施行した．症例は80歳男性で，食道癌に対する胸骨後... |
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| SubjectTerms | 大動脈弁置換術 胸骨後経路胃管 胸骨正中切開 食道癌 |
| Title | 食道癌に対する胸骨後経路胃管再建術後の冠動脈バイパス術併施大動脈弁置換術の1例 |
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