Left brachiocephalic vein injury during esophagectomy

Abstract

Left brachiocephalic vein injury has not yet been reported during reconstruction after esophagectomy. A 58-year-old male patient was diagnosed with cervical esophageal squamous cell carcinoma and subsequently underwent subtotal esophagectomy followed by neo-adjuvant chemotherapy. The left brachiocephalic vein was accidentally injured when making a retrosternal space. The brachiocephalic vein was ligated followed by rapid sternotomy, and cervical esophagostomy without tumor resection and jejunostomy were performed for damage control. Complete resection of the cervical esophageal tumor and free jejunal transplantation for reconstruction were performed 55 days after the initial surgery. The patient is now well and has survived for more than 34 months after the reconstruction. Surgeons should consider left brachiocephalic vein injury when making a retrosternal space. Damage control surgery and preparation for a second surgery may be important in cases of accidental major vascular injury during esophagectomy.