[A case of stenosis of the reconstructed jejunum due to recurrent cancer after total gastrectomy in which stent-in-stent placement was effective].

OBJECTIVES

We report one case of stenosis of the reconstructed jejunum due to recurrent cancer after total gastrectomy in which stenting was effective and good QOL was achieved.

CASE: The patient was a 70-year-old woman. In July 2000, the patient underwent total gastrectomy.Roux-en Y reconstruction with a diagnosis of gastric cancer. The pathological diagnosis was U-Post, Type 3, por 1, T3, N1, H0, P0, CY0, M0, and Stage IIIA. From 9 months after the operation, aphagia occurred and stenosis of the reconstructed jejunum was noted. Based on a biopsy of the stenosis, a diagnosis of post-operative recurrent gastric cancer was made. Although the patient received two cycles of low-dose FP therapy, complete response was not obtained, and the patient stayed at home under the IVH control for about 4 months. In June 2001, the patient was hospitalized for a stent placement due to the patient's request.

METHOD: After a guide wire was endoscopically inserted and a good passage on the anal side of the stenosis was confirmed, a stent was placed. Self Expandable Metallic Stent (SEMS) was used.

CLINICAL COURSE: Following the stent placement, the patient was able to ingest orally, but 6.5 months later, stenotic symptoms developed and another stent was deployed (stent in stent).

CONCLUSION

Stenting is relatively simple and less invasive, which is useful for the improvement of QOL and in recurrent cases as well.