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Thoracoscopic esophagectomy with dissection in the prone position for esophageal cancer and pulmonary vein injury
Case Report: A male patient, 62 years old, with no relevant comorbidities , was admitted in the Oncology Surgery Department on December, 2019. He denied alcohol consumption and he was current smoker, reporting and smoking history of 20 pack years. The patient's main symptom was solid food dysphagia for 2 months. He denied weight loss or other constitutive symptoms. The physical examination: ECOG 1, absence of lymph nodes enlargement and abdomen with no abnormalities The patient underwent upper endoscopic with the diagnosis of vegetating lesion occupying 2/3 of the lumen in the middle third of the esophagus, with no other findings. The histopathological diagnosis was compatible with Squamous Cell Carcinoma. Staging CT scans of thorax and abdomen demonstrated obliterating lesion of the lower middle esophagus, with mediastinal lymph node enlargement, with unaltered upper abdomen and pelvis CT imaging. Patient underwent preoperative radiotherapy associated to cytotoxic therapy with carboplatin and paclitaxel. Response tumor evaluation was compatible with partial tumor response, and surgical tumor resection was proposed. Patient submitted to esophagogastrectomy with gastric tube reconstruction, with mediastinal and retroperitoneal lymphadenectomy. Pathological staging ypT3ypN1 (EC IIIB) .
Surgical Procedure Description: Thoracoscopic esophagectomy was performed with dissection, with patient occupying the prone position. During esophageal dissection, inadvertent pulmonary vein injury has occurred , as shown in the reported-video. Identification of the lesion, and videolaparoscopic suture was successfully performed, and the surgical procedure was carried out without other complications.
esophageal cancer, thoracoscopic, pulmonary vein injury
Trato gastrointestinal alto*
JUNEA CARIS DE OLIVEIRA, CELSO ROBERTO PASSERI, EDUARDO MARCUCCI PRACUCHO, KARLA THAIZA TOMAL, RENATO MORATO ZANATTO, VITOR AUGUSTO MELÃO MARTINHO