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World Journal of Surgery

, Volume 42, Issue 5, pp 1551–1558 | Cite as

Result of Thoracic Endovascular Aortic Repair for Patients with Esophageal Cancer

  • Akira Matsumoto
  • Yuji Kanaoka
  • Takeshi Baba
  • Reo Takizawa
  • Masayuki Hara
  • Koji Maeda
  • Katsunori Nishikawa
  • Yutaka Suzuki
  • Katsuhiko Yanaga
  • Takao Ohki
Original Scientific Report

Abstract

Background

Bleeding from the thoracic aorta is potentially fatal in patients with advanced esophageal cancer. Thoracic endovascular aortic repair (TEVAR) was recently applied for aortic invasion by esophageal cancer. However, only a few case reports have been published. This study was performed to clarify the effectiveness and safety of TEVAR for patients with advanced esophageal cancer.

Methods

We retrospectively reviewed 18 patients who underwent TEVAR for esophageal cancer. We also performed a literature search and reviewed 21 similar cases.

Results

From 2007 to 2016, 10 patients were treated on an emergent basis for aortic hemorrhage (salvage group) and 8 patients underwent urgent prophylactic surgery (prophylactic group). Hemostasis was achieved in all cases. One (10%) patient in the salvage group died of aspiration pneumonia on postoperative day 1, while all patients in the prophylactic group survived for >1 month. The median survival period in the salvage and prophylactic group was 3.25 and 11.10 months, respectively. The longest survivor was still alive 9 years after TEVAR and chemoradiotherapy. No fatal adverse events or negative impacts on subsequent treatment for esophageal cancer occurred.

Conclusions

TEVAR is feasible, safe, and effective in preventing fatal aortic hemorrhage secondary to esophageal cancer invasion, although it is palliative in most cases. Because the outcomes of emergent TEVAR after bleeding tended to be worse in the salvage than in prophylactic group, prophylactic TEVAR may be considered a viable treatment option for patients with aortic invasion by advanced esophageal cancer.

Notes

Compliance with ethical standards

Conflict of interest

Dr. Takao Ohki is a paid consultant for W.L. Gore. The remaining authors declare that they have no competing interests.

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Copyright information

© Société Internationale de Chirurgie 2017

Authors and Affiliations

  • Akira Matsumoto
    • 1
  • Yuji Kanaoka
    • 1
  • Takeshi Baba
    • 1
  • Reo Takizawa
    • 1
  • Masayuki Hara
    • 1
  • Koji Maeda
    • 1
  • Katsunori Nishikawa
    • 1
  • Yutaka Suzuki
    • 2
  • Katsuhiko Yanaga
    • 1
  • Takao Ohki
    • 1
  1. 1.Department of SurgeryJikei University School of MedicineTokyoJapan
  2. 2.Department of SurgeryInternational University of Health and Welfare HospitalNasushiobara CityJapan

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