Nakayama esophagoduodenostomy as a reconstructive stage after gastrectomy for gastric cancer complicated by acute bleeding and Krukenberg metastases. Clinical case

Abstract

Purpose - on a clinical case to justify the technical aspects of applying the Nakayama esophago-duodenostomy as a reconstructive stage after gastrectomy for gastric cancer complicated by acute bleeding and Krukenberg metastases. Clinical case. Patient O., born in 1975, was being treated for stomach cancer complicated by moderate acute bleeding and Krukenberg metastases in the surgery department No. 3 of the Kyiv City Emergency Clinical Hospital. The patient general clinical, special laboratory and instrumental research methods were carried out (electrocardiography, esophagogastroduodenoscopy, ultrasound examination of the organs of the abdominal cavity and small pelvis, computer tomography of the organs of the abdominal cavity and small pelvis with intravenous contrast). The patient had cancer of the cardiac part of the stomach, complicated by moderate gastrointestinal bleeding with the presence of Krukenberg metastases, in connection with which the patient underwent surgery in the early delayed period according to a unique method - gastrectomy with lymphodissection in the volume of D2+ and overlapping esophageal-duodenal anastomosis according to the Nakayama type in the modification of the clinic. The patient was discharged in a satisfactory condition on the 10th day after surgery under the supervision of an oncologist and a surgeon at her place of residence. During the dynamic observation for 12 months, she felt satisfactory. Conclusions. Using the example of a clinical case, the technical aspects of applying the Nakayama esophagoduodenostomy as a reconstructive stage after gastrectomy for gastric cancer complicated by acute bleeding and Krukenberg metastases are substantiated. The research was carried out in accordance with the principles of the Helsinki Declaration. The informed consent of the patient was obtained for conducting the studies. No conflict of interests was declared by the authors.