Takahiro Kenmochi

Clinical analysis of reflux esophagitis following esophagectomy with gastric tube reconstruction

BackgroundRecently, the rate of postoperative long-term survival has increased in cases of esophageal cancer. We report on our analysis of postoperative reflux esophagitis (RE) at Tokai University.MethodsWe enrolled 48 patients who underwent gastric tube reconstruction after esophagectomy. The diagnosis of RE was confirmed by endoscopy.ResultsOf the 48 patients, 28 (58.3%) were found to have RE. Among the 28 patients with RE, only four (14.3%) reported symptoms. The distribution of the severity of RE according to the Los Angeles classification in the patients was as follows: grade M, 1 (3.6%); grade A, 2 (7.1%); grade B, 6 (21.4%); grade C, 17 (60.7%); and grade D, 2 cases (7.1%). Barretts epithelium was detected in 9 of the 28 patients (31%) with RE and in 3 of the 20 (15%) patients with no evidence of RE.ConclusionsTo detect the presence of RE as well as monitor for recurrence and development of metachronous cancer, we consider it important to perform endoscopy regularly over the long term. As Barretts epithelium is frequently encountered, care should be exercised to detect the specialized columnar epithelium showing dysplastic changes.

Superficial Esophageal Cancer Treated by Radical Surgery: Case Study

The diagnostic criteria for intraepithelial cancer of the esophagus are different between Western countries and Japan. In Western countries only the malignant tumor invading the lamina propria mucosae seems to be regarded as cancer [1]. We report a case of esophageal cancer invading the submucosal layer diagnosed by typical upper gastrointestinal and endoscopic findings. It was treated by radical surgery.

The Efficacy of Calcium Mupirocin for Esophageal Cancer Operation.

ムピロシン軟膏の使用で食道癌術後のMRSA感染症が減少するかを検討した.食道癌手術予定の患者54例全例にムピロシン軟膏を使用した.術前に1日3回, 3日間鼻前庭部に左右それぞれ30mgずつ塗布した.Historical controlとしてそれ以前の症例47例を対照とし比較検討した.対照群では47例中9例 (19.1%)にMRSAが検出された.ムピロシン使用群では54例中2例 (3.7%)にMRSAが検出され, MRSA感染症はそのうちの1例 (1.85%)であった.培養された菌の中で最も多かったのは両群とも緑膿菌であった.食道癌手術に対しムピロシン軟膏を使用することでMRSA感染は減少させることが可能である.食道癌手術に対するムピロシンの投与は非常に有用であると考えられた.