title: Tracheal compression by the gastric tube in esophageal cancer with ankylosing spondylitis and an analysis of the mediastinal condition in 84 cases of esophagectomy: report a case.
abstract: Pneumonia, recurrent nerve injury and anastomotic leakage are common complications occurring after esophagectomy. However, there have so far been few reports on tracheal compression by the gastric tube. The patient was a 66-year-old female with a history of ankylosing spondylitis and esophageal superficial squamous carcinoma treated with endoscopic mucosal resection. The new lesion was located just next to the last treated lesion. Therefore, it was difficult to treat this lesion endoscopically because of severe stenosis and scarring due to the previous treatment. Transhiatal esophagectomy was therefore performed. However, severe tracheal obstruction occurred following extubation after the surgery due to compression caused by the gastric tube. This case was successfully treated with a mediastinal pleural incision through a right thoracotomy. The distance between the sternum and the vertebra in this case was narrower than normal, thereby inducing this rare condition.
authors.affiliation: Department of Frontier Surgery, Graduate School of Medicine, Chiba University, 1-8-1 Inohana, Chuo-ku, Chiba 260-8670, Japan. nikeda-cib@graduate.chiba-u.jp
authors.forename: Norimasa
authors.initials: N
authors.lastname: Ikeda
authors.forename: Yasunori
authors.initials: Y
authors.lastname: Akutsu
authors.forename: Kiyohiko
authors.initials: K
authors.lastname: Shuto
authors.forename: Takayuki
authors.initials: T
authors.lastname: Tohma
authors.forename: Hisahiro
authors.initials: H
authors.lastname: Matsubara
mesh_terms: D000368:Aged; D000402:Airway Obstruction / Q000209:etiology*; D002294:Carcinoma, Squamous Cell / Q000601:surgery*; D004938:Esophageal Neoplasms / Q000601:surgery*; D016629:Esophagectomy / Q000379:methods*; D004945:Esophagoscopy; D005260:Female; D006801:Humans; D007441:Intubation, Gastrointestinal / Q000009:adverse effects*; D008482:Mediastinum / Q000601:surgery; D010994:Pleura / Q000601:surgery; D011183:Postoperative Complications / Q000209:etiology*; D013131:Spine / Q000002:abnormalities; D013167:Spondylitis, Ankylosing / Q000150:complications*; D015607:Stents; D013249:Sternum / Q000002:abnormalities; D013908:Thoracotomy / Q000379:methods*; D014135:Tracheal Stenosis / Q000209:etiology*; D016896:Treatment Outcome