Coloplasty for Cardioesophageal Junction Cancer

Surgery for gastric cancer remains a challenge for surgeons all over the world. One of the difficult problems in this pathology is the management of patients with the spread of the tumor to adjacent organs and high length of esophageal tumor lesion. The choice of access, surgical tactics and plastic procedure depends on the level of spread in esophagus.

It is important to remember that resection of the esophagus in these patients should be done at a distance of 4-5 cm from the proximal edge of the tumor, which significantly reduces the likelihood of local recurrence in anastomosis.

In patients with cardioesophageal cancer with the spread of abdominal segment adequate resection can be reached from the abdominal access. When prenical segment is involved with tumor anastomosis must be formed at the level of the proximal part of retropericardial segment below the bifurcation of the trachea. We choose Transthoracic approach for this procedure.

The most difficult is the surgical treatment of patients with damage to the retropericardial segment of the esophagus. In such cases, to achieve radical resection the anastomosis should be formed above the level of the bifurcation of the trachea. We believe that in such cases the most effective is the colonoplasty .
In this video we show the clinical case of the patient , 35 years old, diagnosed with gastro- esophageal adenocarcinoma with high spread (29-30 cm from the incisors)The patient was admitted to hospital with a full dysphagia, on the background of GI bleeding.

Video by Ilya Gotsadze (M.D., Ph.D.)