胃癌胃横行結腸瘻に対する結腸弁付加の1経験例

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  • A CASE OF GASTRIC AND TRANSVERESE COLONIC FISTULA DUE TO GASTRIC CANCER WITH USEFUL SURGICAL TECHNIQUE OF ATTACHING A COLONIC VALVE

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The patient, a 62-year-old male, had chief complaints of general malaise and anorexia. Roentgenography of the digestive tract revealed an internal fistula between the stomach and transverse colon and gastric endoscopy revealed a huge elevated lesion with a depressed center at the posterior wall of the greater curvature of the stomach and regurgitation of feces, resulting in a diagnosis of gastric and transverese colonic fistula due to gastric cancer. As surgical excision was impossible, side-to-side anastomosis of the transverse colon and sigmoid colon was performed, and a Perl conical valve was introduced between the anastomotic area of the transverse colon and the fistula. After surgery, the fecal regurgitation disappeared, the patient's general condition improved and a good performance status was acquired over the following ten months. This surgical technique of attaching a conical valve was thought to be useful to prevent contamination of the upper digestive tract due to fecal regurgitation, to improve organ functions and to avoid digestive disturbance. Moreover, 26 cases reported in Japan were reviewed in the light of the related literature and the results are reported in the present paper.

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