RESUMEN
Tracheal rupture is a rare but potentially serious complication of transhiatal esophagectomy (THE). In this situation, ventilation of the patient can be extremely difficult, even impossible, due to excessive gas leakage from tracheal tear. In this case report, we present such a patient in whom emergency thoracotomy and patching of the trachea were performed in order to maintain ventilation and oxygenation.
Asunto(s)
Esofagectomía/efectos adversos , Enfermedades de la Tráquea/etiología , Anciano , Femenino , Humanos , Respiración Artificial , Rotura , ToracotomíaRESUMEN
Esophagectomy without opening the thoracic cavity--transhiatal esophagectomy--(THE) were performed in 47 patients with malignant tumors localized at various levels of the esophagus. Pulmonary function studies were performed in all patients and they are categorized as low, moderate, or high risk for probable postoperative pulmonary complications according to the risk category system. Nine of these patients were classified as high risk, seven as moderate risk, and the rest as low risk. In all patients but four, reconstruction was accomplished by using their stomachs as a substitute. In the remaining patient, intestinal continuity was established by a left and right colonic interposition. Three patients were lost in the early postoperative period. Two patients categorized as low risk died from pulmonary thromboembolism and cardiac failure, respectively. One patient categorized in the high risk group died of coronary thrombosis. Postoperative complications included transient hoarseness due to recurrent laryngeal nerve paresis in one patient, right pleural effusion in one patient, pneumothorax in two patients, and thrombophlebitis in one patient. In the high risk patient group, there were no pulmonary complications. This clinical study demonstrated the protective effect of THE in patients with serious pulmonary problems.