A Case Report of Resection of Esophageal Cancer with Combined Resection of Left Bronchus

Masazumi Zaima, Akira Mitsuyoshi, Naoyuki Fujimura

Department of Surgery, Mitsubishi Kyoto Hospital

The operative procedure of resection of thoracic esophageal cancer with combined resection and reconstruction of the left main bronchus is described. The patient was a 76-year-old man who had an advanced esophageal cancer in the middle third of the thoracic esophagus. Bronchofiberscopic examination revealed cancer involvement of the left main bronchus. A radical esophagectomy was carried out through a right thoracotomy, and approximately 3 cm of the left bronchus was resected en bloc with the tumor. During the resection and reconstruction of the bronchus, mechanical ventilation was interrupted to obtain a good operative field but only high-frequency jet ventilation was provided for the right lung. The alimentary tract was reconstructed with cervical anastomosis using the gastric tube through the posterior mediastinum. The posterior mediastinum was filled with omental adipose tissue to suppor the bronchial anastomosis. The postoperative course was uneventful and no complication caused by bronchial reconstruction was noted. These results suggest that the operative procedure described here is a safe and simple method for the surgical treatment of avanced esophageal cancer involving the bronchus.

Key words
esophaeal cancer, resection and reconstruction of bronchus

Reprint requests
Masazumi Zaima Department of Surgery, Mitsubishi Kyoto Hospital
1 Goshomachi, Katsura, Nishikyo-ku, Kyoto 615-8087 JAPAN

Accepted
April 22, 1998

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