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J Thorac Cardiovasc Surg 2006;131:488-489
© 2006 The American Association for Thoracic Surgery

Brief Communication

An alternative method for the removal of thoracic esophagus without thoracotomy

Pei-Ming Huang, MD a , b , Ke-Cheng Chen, MD a , b , Yung-Chie Lee, MD, PhD a , b , *

a Department of Surgery, National Taiwan University Hospital, and National Taiwan University College of Medicine, Taipei, Taiwan
b Department of Traumatology, National Taiwan University Hospital, and National Taiwan University College of Medicine, Taipei, Taiwan

Received for publication August 3, 2005; accepted for publication August 31, 2005.

* Address for reprints: Yung-Chie Lee, MD, PhD, Division of Thoracic Surgery, Departments of Surgery and Traumatology, National Taiwan University Hospital No. 7, Chung-Shan S Rd, Taipei 100, Taiwan (Email: wuj@ha.mc.ntu.edu.tw).

The first 20% of the full text of this article appears below.

Resection of the esophagus without thoracotomy can be achieved by blunt finger dissection. The esophagus is mobilized from both ends, with dissection performed somewhere in the middle through areolar tissue, a procedure that usually encounters difficulty. As an alternative, everting stripping of the thoracic esophagus requires gastrostomy or esophagostomy to facilitate vein stripper fixation. However, in perforation or severe stenosis of the esophagus, the stripper is more difficult to apply. To simplify the esophagectomy procedure, we present a new approach.

Clinical Summary

A 54-year-old man had a history of perforated peptic ulcer status post subtotal gastrectomy 30 years previously. He was admitted to our hospital with massive hematemesis. On arrival at the emergency room, shock was noted, and a Sengstaken-Blakemore tube was inserted empirically. He underwent emergent angiography, which showed active left gastric artery bleeding. Unfortunately, chest radiograph examination showed mediastinal air behind the heart. A diagnosis of esophageal rupture was highly suspected upon computed tomography of the chest . . . [Full Text of this Article]






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