Bilateral Approach for Thoracoscopic Esophagectomy in a Patient with Esophageal Cancer and Solitary Posterior Thoracic Para-aortic Lymph Node Metastasis.
bilateral approach
posterior thoracic para-aortic lymph node
thoracoscopic esophagectomy
Journal
Acta medica Okayama
ISSN: 0386-300X
Titre abrégé: Acta Med Okayama
Pays: Japan
ID NLM: 0417611
Informations de publication
Date de publication:
Dec 2020
Dec 2020
Historique:
entrez:
28
12
2020
pubmed:
29
12
2020
medline:
8
9
2021
Statut:
ppublish
Résumé
We report a successful dissection of metastatic posterior thoracic para-aortic lymph node (No. 112aoP) via bilateral thoracoscopic surgery. With the anesthetized patient (a 73-year-old Japanese woman) in the prone position, two working ports were inserted for the left-side approach, and artificial pneumothorax was created. Thoracoscopic examination revealed a swollen LN posterior to the descending aorta. Fat and metastatic LNs posterior to the aorta were dissected from the aortic arch level to the diaphragm while preserving intercostal arteries. For the right-side approach, two working ports were inserted and a routine thoracoscopic esophagec-tomy was performed. Gastric conduit reconstruction was achieved laparoscopically. Operation time for the left thoracic procedure: 54 min; estimated blood loss: almost none. No recurrence was detected 24 months post-operatively. There are several surgical options for approaching No. 112aoP, including transhiatal, left thora-cotomy, and thoracoscopy. Although a wide dissection of the posterior thoracic para-aortic area has not been reported, it may be feasible and safe if the artery of Adamkiewicz and intercostal arteries are preserved. A min-imally invasive bilateral thoracoscopic approach for a thoracoscopic esophagectomy is safe and useful for esophageal cancer patients with solitary No. 112aoP metastasis.
Types de publication
Case Reports
Langues
eng
Sous-ensembles de citation
IM
Pagination
521-524Déclaration de conflit d'intérêts
No potential conflict of interest relevant to this article was reported.
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