Successful robot-assisted minimally invasive surgery for scirrhous gastric conduit cancer after esophagectomy - case report

Sep 23, 2026

Patients with reconstructed gastric conduit cancer following esophageal cancer surgery can be treated via gastric conduit resection and regional lymph node dissection to achieve pathological R0 resection, though adhesions, scars, and anatomical irregularities complicate these procedures. Robotic resection for scirrhous gastric conduit cancer extending along most of the reconstructed conduit has not been reported. This case describes a 69-year-old man undergoing radical robot-assisted surgery for advanced disease with regional lymph node metastases, after prior robot-assisted thoracoscopicesophagectomy and reconstruction.

LanguageEnglish

CategoryHealthcare

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Pages10

Reading Time25 min

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Abstract

Introduction

Robot-Assisted Minimally Invasive Esophagectomy (RAMIE)

ONCOLOGY LETTERS 30: 337, 2025 Successful robot‑assisted minimally invasive surgery for scirrhous gastric conduit cancer after esophagectomy: A case report KOICHI OKAMOTO 1 , YUTA SANNOMIYA 1 , KOKI FURUSE 1 , KAORI MARUYAMA 1 , HISASHI NISHIKI 1 , AKIFUMI HASHIMOTO 1 , DAISUKE KAIDA 1 , TAKASHI MIYATA 1 , TOSHIKATSU TSUJI2 , HIDETO FUJITA 1 , NORIYUKI INAKI2 , SHINICHI KINAMI 1,3 , ITASU NINOMIYA4 and HIROYUKI TAKAMURA 1 1 Department of General and Digestive Surgery, Kanazawa Medical University Hospital, Kahoku, Ishikawa 920‑0293, Japan; Department of Gastrointestinal Surgery, Kanazawa University Hospital, Kanazawa, Ishikawa 920‑8641, Japan; 2 3 Department of General and Digestive Surgery, Himi Principal Hospital Kanazawa Medical University, Himi, Toyama 935‑8531, Japan; Department of Surgery, Fukui Prefectural Hospital, Fukui, Fukui 910‑0846, Japan 4 Received December 14, 2024; Accepted April 8, 2025 DOI: 10. 3892/ol.2025.15083 Abstract. Patients with reconstructed gastric conduit cancer following esophageal cancer surgery can be treated through gastric conduit resection and regional lymph node dissection for pathological R0 resection. However, these procedures are difficult owing to the adhesions and scars around the gastric conduit and anatomical irregularities . To the best of our knowledge, robotic resection for scirrhous gastric conduit cancer occurring along almost the entire reconstructed gastric conduit has not been reported in the literature to date . The present study report the case of a 69‑year‑oldman who underwent radical robot‑assisted surgery for advanced gastric conduit cancer along most of the gastric conduit with regional lymph node metastases . The patient had previously undergone robot‑assisted thoracoscopicesophagectomy and posterior mediastinal gastric conduit reconstruction for thoracic esophageal cancer at another hospital. Subsequently, 5 years later, the patient underwent esophagogastroduodenoscopy for a passage disorder, during which an elevated lesion with severe stenosis was found at the esophagogastric anastomosis, along with mucosal Correspondence to: Dr Koichi Okamoto, Department of General and Digestive Surgery, Kanazawa Medical University Hospital, 1‑1 Daigaku, Uchinadamachi, Kahoku, Ishikawa 920‑0293, Japan E‑mail: kokamoto@kanazawa‑[med.ac.jp](med.ac.jp) Abbreviations: SCC, squamous‑cell carcinoma; GCC, gastric conduit cancer; CT, computed tomography; EBD, endoscopic balloon dilation; ESD, endoscopic submucosal dissection; HP, Helicobacter pylori; ICG, indocyanine green; LN, lymph‑node; OS, overall survival; RAMIE, robot‑assisted minimally invasive esophagectomy Key words: robotic surgical procedures, robotics, adenocarcinoma, scirrhous gastric cancer, esophagectomy, remnant gastric cancer, gastric conduit cancer irregularity along the reconstructed gastric conduit that was then pathologically diagnosed as poorly differentiatedadenocarcinoma . Thereafter, the patient was referred to Kanazawa Medical University Hospital (Kahoku, Japan) where he underwent robotic intrathoracic surgery. Forceps manipulations under a three‑dimensional magnified view were conducted to dissect the adhesions around the lung, chest wall, tracheal membranous portion and reconstructed gastric conduit . Curative total remnant gastrectomy with lymph node dissection and digestive‑tract reconstruction using a pedicled jejunum were conducted without severe intraoperative injuries. Pathological analysis of the resected specimen indicated scirrhous gastric conduit cancer origi‑ nating along the gastric conduit with marked full‑thickness fibrosis and clusters of adenocarcinoma cells . No obvious cancer remnants were found on the dissected surface of the subserous layer of the gastric conduit. After postoperative adjuvant chemotherapy with oral tegafur/gimeracil/oteraciland intravenous docetaxel for 4 months, the patient was alive without recurrence at 9 months postoperatively. Introduction

FAQs

What challenges make gastric conduit resection after esophagectomy difficult?

Adhesions and scars around the gastric conduit, along with anatomical irregularities, make the procedures technically challenging.

Why is robotic surgery considered advantageous in this setting?

Robotic surgery offers a 3D magnified view, high maneuver freedom, reduced missed movements from hand tremor, and improved precision and gentleness for intrathoracic dissection.

What was the outcome for the reported patient after robotic surgery?

The patient underwent curative total remnant gastrectomy with lymph node dissection and reconstruction; pathological findings showed scirrhous gastric conduit cancer, and the patient remained alive without recurrence at 9 months postoperatively after adjuvant chemotherapy.

Sep 23, 2026

Uploaded by Taylor Morgan