A Case Report of Esophageal Cancer using the Latissimus Dorsi Muscle Flap with Subcutaneous Fat Tissue for the Repair of the Left Main Bronchial Defect

An 81-year-old man was diagnosed with an esophageal cancer in the middle thoracic esophagus. A CT scan and a bronchofiberscopic examination suggested that the cancer might not have invaded the left main bronchus. Following a right lateral thoracotomy without cutting the right latissimus dorsi muscle...

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Published inThe Japanese Journal of Gastroenterological Surgery Vol. 35; no. 5; pp. 566 - 570
Main Authors Kato, Takeshi, Yamamoto, Hitoshi, Endo, Wakio, Kimura, Yutaka, Kikkawa, Nobuteru, Urano, Naomi, Kurokawa, Eiji, Tanigawa, Takahiko, Hayashi, Taro, Goto, Masashi
Format Journal Article
LanguageJapanese
Published The Japanese Society of Gastroenterological Surgery 2002
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ISSN0386-9768
1348-9372
DOI10.5833/jjgs.35.566

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Abstract An 81-year-old man was diagnosed with an esophageal cancer in the middle thoracic esophagus. A CT scan and a bronchofiberscopic examination suggested that the cancer might not have invaded the left main bronchus. Following a right lateral thoracotomy without cutting the right latissimus dorsi muscle, a radical esophagectomy was performed, and the membranous wall of the left main bronchus was partially resected because the tumor could not be isolated from the membranous wall. A latissimus dorsi muscle flap with the subcutaneous fat tissue on the distal part was created, and the bronchial defect was covered by the inner side of the muscle flap. No air leakage was noted during positive pressure ventilation or coughing, and the postoperative course was uneventful. We conclude that coverage of the latissimus dorsi muscle flap with subcutaneous fat tissue is a useful technique that can be used to prevent postoperative complications in patients requiring a combined resection of the membranous wall for the treatment of esophageal cancer.
AbstractList An 81-year-old man was diagnosed with an esophageal cancer in the middle thoracic esophagus. A CT scan and a bronchofiberscopic examination suggested that the cancer might not have invaded the left main bronchus. Following a right lateral thoracotomy without cutting the right latissimus dorsi muscle, a radical esophagectomy was performed, and the membranous wall of the left main bronchus was partially resected because the tumor could not be isolated from the membranous wall. A latissimus dorsi muscle flap with the subcutaneous fat tissue on the distal part was created, and the bronchial defect was covered by the inner side of the muscle flap. No air leakage was noted during positive pressure ventilation or coughing, and the postoperative course was uneventful. We conclude that coverage of the latissimus dorsi muscle flap with subcutaneous fat tissue is a useful technique that can be used to prevent postoperative complications in patients requiring a combined resection of the membranous wall for the treatment of esophageal cancer.
Author Kato, Takeshi
Yamamoto, Hitoshi
Tanigawa, Takahiko
Urano, Naomi
Kikkawa, Nobuteru
Endo, Wakio
Kimura, Yutaka
Kurokawa, Eiji
Goto, Masashi
Hayashi, Taro
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  fullname: Yamamoto, Hitoshi
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  fullname: Endo, Wakio
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  fullname: Kimura, Yutaka
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  fullname: Kikkawa, Nobuteru
  organization: Department of Surgery, Minoh City Hospital
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  fullname: Urano, Naomi
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  fullname: Kurokawa, Eiji
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  fullname: Tanigawa, Takahiko
  organization: Department of Surgery, Minoh City Hospital
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  fullname: Hayashi, Taro
  organization: Department of Surgery, Minoh City Hospital
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  fullname: Goto, Masashi
  organization: Department of Surgery, Minoh City Hospital
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References 10) 鶴丸昌彦, 秋山洋: 気管膜様部を損傷した. 臨外39: 755, 1976
2) Ancona E, Ruol A, Castro C et al: First-line chemotherapy improves the resection rate and longterm survival of locally advanced (T4, any N, M0) squamous cell carcinoma of the thoracic esophagus. Ann Surg 226: 714-724, 1997
3) 川原英之, 藤田博正, 日高正晴ほか: 食道癌の気管または気管膜様部合併切除例における広背筋有茎筋弁補強術式の有用性. 日外会誌85: 300-306, 1984
9) 甲利幸, 安田卓司, 児玉憲ほか: 胸部食道癌に対する気管, 気管支合併切除術. 手術51: 585-595, 1997
4) 川原英之, 白石武史, 吉田泰憲ほか: 隣接臓器浸潤胸部食道癌の外科治療. 手術46: 865-878, 1992
11) 坪田紀明, 吉村雅裕, 八田健ほか: 気管合併切除を行った食道癌の2例-大網による補強の重要性について-. 日外会誌91: 142-145, 1990
8) 藤田博正, 掛川暉夫, 山名秀明: 進行食道癌手術における広背筋皮弁の利用. 手術46: 897-905, 1992
12) 江口礼紀, 井手博子: 気管, 気管支, 大動脈浸潤胸部食道癌の手術. 手術51: 585-595, 1997
6) 綾部公懿, 原信介, 岡忠之ほか: 合併切除が有用なT4手術症例の手術. 日外会誌98: 773-777, 1997
1) 青山法夫, 小泉博義: 食道癌T4 (A3) 症例におけるNeoadjuvant 療法の適応と手術治療. 日外会誌98: 761-766, 1997
5) Fujita H, Kawahara H, Kakegawa T et al: Intrathoracic application of the latissimus dorsi muscle for esophageal cancer operation. Jpn J Surg 17: 217-219, 1987
7) 松原敏樹, 植田守, 中島聰總ほか: 気管, 気管支浸潤胸部食道癌. 外科55: 1395-1400, 1993
References_xml – reference: 3) 川原英之, 藤田博正, 日高正晴ほか: 食道癌の気管または気管膜様部合併切除例における広背筋有茎筋弁補強術式の有用性. 日外会誌85: 300-306, 1984
– reference: 7) 松原敏樹, 植田守, 中島聰總ほか: 気管, 気管支浸潤胸部食道癌. 外科55: 1395-1400, 1993
– reference: 11) 坪田紀明, 吉村雅裕, 八田健ほか: 気管合併切除を行った食道癌の2例-大網による補強の重要性について-. 日外会誌91: 142-145, 1990
– reference: 5) Fujita H, Kawahara H, Kakegawa T et al: Intrathoracic application of the latissimus dorsi muscle for esophageal cancer operation. Jpn J Surg 17: 217-219, 1987
– reference: 12) 江口礼紀, 井手博子: 気管, 気管支, 大動脈浸潤胸部食道癌の手術. 手術51: 585-595, 1997
– reference: 8) 藤田博正, 掛川暉夫, 山名秀明: 進行食道癌手術における広背筋皮弁の利用. 手術46: 897-905, 1992
– reference: 4) 川原英之, 白石武史, 吉田泰憲ほか: 隣接臓器浸潤胸部食道癌の外科治療. 手術46: 865-878, 1992
– reference: 9) 甲利幸, 安田卓司, 児玉憲ほか: 胸部食道癌に対する気管, 気管支合併切除術. 手術51: 585-595, 1997
– reference: 10) 鶴丸昌彦, 秋山洋: 気管膜様部を損傷した. 臨外39: 755, 1976
– reference: 2) Ancona E, Ruol A, Castro C et al: First-line chemotherapy improves the resection rate and longterm survival of locally advanced (T4, any N, M0) squamous cell carcinoma of the thoracic esophagus. Ann Surg 226: 714-724, 1997
– reference: 1) 青山法夫, 小泉博義: 食道癌T4 (A3) 症例におけるNeoadjuvant 療法の適応と手術治療. 日外会誌98: 761-766, 1997
– reference: 6) 綾部公懿, 原信介, 岡忠之ほか: 合併切除が有用なT4手術症例の手術. 日外会誌98: 773-777, 1997
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Snippet An 81-year-old man was diagnosed with an esophageal cancer in the middle thoracic esophagus. A CT scan and a bronchofiberscopic examination suggested that the...
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StartPage 566
SubjectTerms esophageal cancer
latissimus dorsi muscle flap
repair of the left main bronchial defect
Title A Case Report of Esophageal Cancer using the Latissimus Dorsi Muscle Flap with Subcutaneous Fat Tissue for the Repair of the Left Main Bronchial Defect
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