title: Esophagectomy combined with aortic segment replacement for esophageal cancer invading the aorta.
abstract: BACKGROUND
  Surgical treatment for patients with esophageal carcinoma that invades the aorta locally (stage IIIc) remains a considerable challenge. This study aimed to introduce radical esophagectomy combined with off-pump descending aorta replacement in these patients and to assess the effects on both short-term and long-term outcomes.
  
  
  METHODS
  The clinical data of 47 patients who had esophageal carcinoma invading the descending aorta and who underwent radical esophagectomy combined with off-pump aortic replacement between January 2001 and March 2012 in Jinling Hospital were retrospectively reviewed. The intraoperative, early postoperative, and follow-up results were analyzed.
  
  
  RESULTS
  Overall, 80.9% and 19.1% of the patients had histopathologically confirmed aortic tunica adventitia invasion and media invasion, respectively. All patients received complete resection (R0) with an average intraoperative blood loss of 227.6±63.3 mL. The mean operative time and aortic cross-clamping time were 4.9±1.3 hours and 17.0±3.2 minutes, respectively. Complications were observed in 59.6% of patients, with no hospital mortality, and all patients resumed an oral diet 1 month after the procedure. The overall 1-, 3-, and 5-year survival rates were 80.9%, 44.7%, and 21.3%, respectively, with a median survival time of 33.6 months.
  
  
  CONCLUSIONS
  In patients with esophageal carcinoma invading the aorta, it is feasible and safe to perform radical esophagectomy combined with off-pump descending aorta replacement to improve nutritional status and achieve satisfactory survival.
authors: Department of Cardiothoracic Surgery, Jinling Hospital, Medical School of Nanjing University, Nanjing, China.
authors: Zhuangzhuang
authors: Z
authors: Cong
authors: Department of Medical Imaging, Jinling Hospital, Medical School of Nanjing University, Nanjing, China.
authors: Qiang
authors: Q
authors: Diao
authors: Department of Cardiothoracic Surgery, Jinling Hospital, Medical School of Nanjing University, Nanjing, China.
authors: Jun
authors: J
authors: Yi
authors: Department of Cardiothoracic Surgery, Jinling Hospital, Medical School of Nanjing University, Nanjing, China.
authors: Lei
authors: L
authors: Xiong
authors: Department of Cardiothoracic Surgery, Jinling Hospital, Medical School of Nanjing University, Nanjing, China.
authors: Haiwei
authors: H
authors: Wu
authors: Department of Cardiothoracic Surgery, Jinling Hospital, Medical School of Nanjing University, Nanjing, China.
authors: Tao
authors: T
authors: Qin
authors: Department of Cardiothoracic Surgery, Jinling Hospital, Medical School of Nanjing University, Nanjing, China.
authors: Hua
authors: H
authors: Jing
authors: Department of Cardiothoracic Surgery, Jinling Hospital, Medical School of Nanjing University, Nanjing, China.
authors: Demin
authors: D
authors: Li
authors: Department of Cardiothoracic Surgery, Jinling Hospital, Medical School of Nanjing University, Nanjing, China. Electronic address: czz061231007@126.com.
authors: Yi
authors: Y
authors: Shen
mesh_terms: D001013:Aorta, Thoracic; D019917:Blood Vessel Prosthesis Implantation; D002294:Carcinoma, Squamous Cell / Q000473:pathology* / Q000601:surgery*; D004938:Esophageal Neoplasms / Q000473:pathology* / Q000601:surgery*; D016629:Esophagectomy; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009361:Neoplasm Invasiveness; D012189:Retrospective Studies; D019043:Vascular Neoplasms / Q000473:pathology* / Q000601:surgery*
keywords: 7