Surgical treatment for superficial esophageal cancer with liver cirrhosis and esophageal varices: report of a case.
Surgical treatment of esophageal cancer is substantially invasive and often entails some postoperative complications. Perioperative management for patients with liver cirrhosis involves great difficulties. Recently, we conducted an esophagectomy for the treatment of superficial esophageal cancer in a 52-year-old male patient with liver cirrhosis and esophageal varices, with gratifying results. Although the hepatic function was impaired, as indicated by a reduced indocyanine green R15 value of 27.4%, the patient was assessed as capable of tolerating operative procedures. The procedures comprised a subtotal esophagectomy through a transhiatal approach, an anastomosis of the cervical esophagus with a gastric tube via the posterior mediastinal route, and super drainage of the short gastric vein of the gastric tube. The patient had an uneventful postoperative course without any complications such as anastomotic leakage or pneumonia. It is considered practicable to accomplish an esophagectomy by careful appraisal of liver function and planning of the operative procedure and perioperative management even in patients with liver cirrhosis.
Shimakawa
Takeshi
T
Department of Surgery, Tokyo Women's Medical University Medical Center East, Tokyo, Japan.
Naritaka
Yoshihiko
Y
Asaka
Shinichi
S
Isohata
Noriyuki
N
Murayama
Minoru
M
Konno
Soichi
S
Katsube
Takao
T
Ogawa
Kenji
K
D004938:Esophageal Neoplasms / Q000150:complications* / Q000473:pathology / Q000601:surgery*; D004932:Esophageal and Gastric Varices / Q000150:complications* / Q000601:surgery*; D004945:Esophagoscopy; D006801:Humans; D008103:Liver Cirrhosis / Q000150:complications* / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D011182:Postoperative Care; D011860:Radiography, Abdominal; D013902:Radiography, Thoracic; D014057:Tomography, X-Ray Computed