Two Cases of Esophagectomy under Mediastinoscopy in Salvage Surgery for Esophageal Cancer

Kenji Kikuchi, Toshiaki Shichinohe, Shunichi Okushiba¹⁾, Shuuji Kitashiro¹⁾, Yo Kawarada¹⁾, Hiroto Manase²⁾, Satoshi Hirano and Satoshi Kondo

Department of Surgical Oncology, Graduate School of Medicine, Hokkaido University
Department of Surgery, Tonan Hospital¹⁾
Department of Surgery, Asahikawa Red Cross Hospital²⁾

Although salvage esophagectomy after definitive chemoradiation is more invasive than standard esophagectomy and causes many complications, some reports indicate that salvage surgery is more effective than other therapeutic options in recurrent esophageal cancer. Safer surgical procedures must be set for salvage esophagectomy. We conducted salvage esophagectomy under mediastinoscopy for middle and lower esophageal cancer. Case 1: A 56-year-old man diagnosed with stage II esophageal cancer, experienced tumor growth following chemoradiation. Because the tumor was localized in the lower esophagus, we conducted esophagectomy under mediastinoscopy to minimize invasiveness the patient. Minor leakage in the postoperative course was cured with conservative therapy. Case 2: A 54-year-old man diagnosed with stage II esophageal cancer, and undergoing chemoradiation developed esophageal perforation and mediastinitis during therapy that were cured with coservative therapy. At the end of the second course of chemotherapy, he suffered severe esophageal narrowing, so we conducted transhiatal esophagectomy under mediastinoscopy. His postoperative course was good and he was discharged on postoperative day 16.

Key words
mediastinoscopy, salvage, esophagectomy

Reprint requests
Kenji Kikuchi Department of Surgical Oncology, Graduate School of Medicine, Hokkaido University
N15-W7 Kitaku, Sapporo, 060-8648 JAPAN

Accepted
June 27, 2007

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