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Surgical consideration of esophagectomy combined with tracheobronchoplastic procedure for the treatment of esophageal cancer

Surgical consideration of esophagectomy combined with tracheobronchoplastic procedure for the treatment of esophageal cancer

Acta Medica Nagasakiensia 31(1-4): 143-151

Four cases who underwent a resection of the esophagus in combination with tracheobronchoplasty were reported in evaluating an operative efficacy as well as in overcoming a surgically bothersome problem. 1) Obliquely cutting edges of the bronchial stumps, which can adjust to fit the anastomosed bronchi, are a weak point of their approximations because of loss of the supporting ability of the cartilages as indicated in case 1. 2) Combined resection of the esophagus with the bronchus seems to reduce the blood flow in the bronchial anastomotic site. One must account into consideration that bronchial wrapping with the pleura may inhibit a new development of vascular networks in the bronchial anastomosis as shown in case 2. 3) Irradiation of as large 60 Gy interferes with the healing process due to damage of severly fibrous changes with a finding of vasculitis to the bronchial wall as presented in case 3. 4) Inevitable truncal vagotomy by a resection of the esophagus leads at times to bile stasis, followed by cholecystitis and bile-transudation peritonitis, reflecting serious operative insult as exhibited in case 4.

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