Abstract
Combined aortoesophageal resection was performed in 8 patients, including 7 with esophageal carcinoma and 1 with aortoesophageal fistula. Aortic resection procedures included segmental resection with permanent aorto-aortic bypass (1 case), segmental resection with graft interposition (1 case), semicircumferential resection with patch aortoplasty (3 cases), wedge resection with lateral aortorr-haphy (1 case), and resection of adventitia (2 cases). Protective methods during aortic cross-clamping included one aorto-aortic permanent bypass, one subclavian-aortic bypass, and three axillo-femoral bypass. Postoperative complications include mediastinal abscess, paresis, arrythmia, and pneumonia. Five patients with esophageal carcinoma died within 6 postoperative months. In 4 of these 5 nonsurvivors, metastasis to distant organs including the liver, bone and peritoneal cavity were found at the time of death or autopsy. Those early recurrence cases were characterized by skip lesions and extensive lymph node metastasis with extranodal invasion. The clinical benefit of aortoesophageal resection will be attained by careful preoperative evaluation for case selection and a sufficient protective method for aortic cross-clamping.
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Kakegawa T, Takeda H, Iwamoto M, et al. Surgical treatment of esophageal cancer: in special reference to A3 carcinoma of the esophagus. Thoracic Surg 1980; 33: 810–21.
Iizuka T. Surgical treatment for A3 esophageal carcinoma. Thorac Surg 1980; 33: 822–35.
Hollander JE, Quick G. Aortoesophageal fistula: a comprehensive review of the literature. Am J Med 1991; 91:279–87.
Kawahara H, Fujita H, Odagiri S. et al. Combined resection of the thoracic aorta associated with subtotal esophagectomy for carcinoma of the esophagus. Jpn J Surg 1985; 86: 1546–51.
Fujita H, Kawahara H, Odagiri S, et al. Clinical and pathological study on resection of the thoracic aorta associated with esophagectomy for esophageal cancer: indication and method. Jpn J Thorac Surg 1987; 35: 35–41.
Sakurai T, Kawahara H, Shatari T, et al. Management of aortoesophageal fistula due to aortic aneurysm. Thoracic. Surg. 1997; 49: 815–20.
Kawahara H, Fujita H. Combined radical resection of adjacent organs involved by esophageal carcinoma: international trend in general thoracic surgery. Vol. 4, 1988: 262–70.
Fujita H. Analysis of the mode of recurrence after resection of esophageal carcinoma. Jpn J Surg 1984; 85: 17–28.
Adams HD, van Geertruyden HH. Neurologic complications of aortic surgery. Ann Surg 1956; 144: 574–83.
Cooly DA, DeBakey ME, Morris GC. Controlled extracorporeal circulation in surgical treatment of aortic aneurysm. Ann Surg 1957; 146: 473–86.
Kawahara H, Odagiri S, Nakanishi K, et al. The use of the aortic bypass in surgery of esophageal carcinoma invading the thoracic aorta. Rinsho Kyobu Geka 1989; 9: 551–6.
Kabuto T, Kobayashi T, Imaoka S, et al. Combined resection of the aorta for the toracic esophageal carcinoma. Gekachiryou 1989; 60: 622–30.
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Read at the Fifty-first Annual Meeting of the Japanese Association for Thoracic Surgery, Symposium, Tokyo, October 2–4, 1998.
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Ichiyoshi, Y., Kawahara, H., Taga, S. et al. Indications and operative techniques for combined aortoesophageal resection. Jpn J Thorac Caridovasc Surg 47, 318–324 (1999). https://doi.org/10.1007/BF03218018
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DOI: https://doi.org/10.1007/BF03218018