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J Thorac Cardiovasc Surg 2001;121:0386-0388
© 2001 The American Association for Thoracic Surgery

Brief Communications

Paraplegia after esophagectomy: Who are the patients at risk?

Malek G. Massad, MD, Philip E. Donahue, MD, Helene Rubeiz, MD, Allan G. Halline, MD, Arvind Patel, MD, Teralandur Raghunath, MD, Norman Snow, MD, Alexander S. Geha, MD, Chicago, Ill

From the Division of Cardiothoracic Surgery, Department of Surgery, The University of Illinois at Chicago, Chicago, Ill.

Received for publication May 16, 2000. Accepted for publication July 11, 2000. Address for reprints: Malek G. Massad, MD, Division of Cardiothoracic Surgery, University of Illinois at Chicago, 840 S Wood St, CSB Suite 417 (MC 958), Chicago, IL 60612 (E-mail: mmassad@uic.edu).

Paraplegia after esophageal resection for carcinoma of the esophagus is rare. A review of the world literature since 1966 showed that only 4 such cases have been reported.Go Go 1-3 We add a fifth case, that of a patient who was referred to our institution for follow-up after resection of adenocarcinoma of the mid-esophagus. The patient was noted to have paraplegia in the immediate postoperative period, a complication thought to be due to a noncompressive thoracic myelopathy, possibly caused by spinal cord ischemia.

Clinical summary

A 52-year-old man with a history of diabetes mellitus, hypertension, and obesity was admitted to the University of Illinois Hospital 3 months after esophageal resection for carcinoma of the mid-esophagus performed elsewhere. The patient had a history of severe reflux esophagitis complicated by esophageal stricture and Barrett esophagus. He had been treated in the past with several dilatations. Because of symptoms of weight loss and dysphagia to solid food, he underwent an esophagogastroduodenoscopy that showed a sessile ulcerative lesion in the mid-esophagus. Biopsy specimens of that lesion showed a poorly differentiated adenocarcinoma. Subsequently, the patient underwent a subtotal esophagectomy and an intrathoracic esophagogastrostomy performed through a right lateral thoracotomy (Ivor Lewis approach). No perigastric or paraesophageal lymph nodes appeared to be involved. . . . [Full Text of this Article]






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