Successful salvage lymphadenectomy after stent grafting for aortic lymph node recurrence of thoracic esophageal carcinoma: a first case report

摘要

In advanced esophageal carcinoma, aortic complications can be fatal. Here, we report our experience with a patient undergoing salvage lymphadenectomy after preoperative aortic stent grafting for paraaortic lymph node recurrence for esophageal carcinoma. The patient was a 54-year-old man, who underwent subtotal esophagectomy for thoracic esophageal carcinoma. Computed tomography performed 12 months after the initial surgery revealed lymphadenopathy on the left side of the thoracic aorta and radiotherapy was performed for lymph node recurrence. FDG-PET performed after radiotherapy revealed slight growth of the lymph node involvement and an accumulation of FDG. We decided to insert a stent graft into the aorta at the site of tumor invasion before surgery to ensure safety. The tumor was sharply dissected and excised with Cooper's scissors after the aorta had been taped at the levels upstream and downstream from the tumor. After surgery, chylothorax was observed, but resolved with conservative treatment. The patient was discharged 30 days after surgery.