計画的な手術および内視鏡的治療により改善した胃切除術後食道狭窄症の1例

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  • A Case of Planned Treatment for Esophageal Stricture Caused by Reflux Esophagitis after

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A 55-year old man admitted for dysphagia was found in gastrointestinal endoscopy to have reflux esophagitis with severe lower esophageal stenosis. He had undergone subtotal gastrectomy for peptic ulcer perforation 12 years earlier and had diabetes mellitus and pulmonary emphysema. Based on a diagnosis of benign esophageal stricture due to reflux esophagitis, gastrojejunostomy stenosis, and afferent loop syndrome, we planned two-stage surgery for the stenosis followed by endoscopy for the esophageal stricture. We constructed a feeding jejunostomy to remedy his malnutrition, then resected the gastrojejunostomy and conducted Roux-Y reconstruction. The postoperative course was uneventful and he was treated 8times with endoscopic dilation for esophageal stricture with gradual improvement. Treating benign esophageal stricture requires careful planning to avoid postoperative complications.

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