TWO CASES OF ESOPHAGEAL CANCER TREATED BY THORACOSCOPIC ESOPHAGECTOMY AFTER SURGERY FOR A MALIGNANCY OF THE HEAD AND NECK

Abstract

Two cases of esophageal cancer treated by thoracoscopic esophagectomy after radical operation for a malignancy of the head and neck were reported. Case 1; An 80-year-old man was admitted to the hospital because of dysphagia. He was diagnosed as having a thoracic esophageal cancer by a barium meal study. He has had been laryngectomized for a laryngeal cancer 16 years before admission. Thoracoscopic esophagectomy, mediastinal lymphadenectomy and cervical esophagocutaneostomy were performed, followed by reconstruction using stomach through antesternal route with as one-month interval. The histological diagnosis was poorly differentiated squamous cell carcinoma invading the adventitia with lymph node metastasis. The patient recovered uneventfully and has been free from any sings of recurrence for 25 months. Case 2; A 77-year-old asymptomatic man was admitted to the hospital with a diagnosis of middle thoracic esophageal cancer which was detected at evaluation for discomfort in the right chest. He had been laryngectomized for a hypopharyngeal cancer 5 years and 6 months before admission. Thoracoscopic esophagectomy and extended lymphadectomy together with reconstruction using stomach through posterior mediastinum were performed in one stage. Histological diagnosis was moderately differentiated squamous cell carcinoma invading the muscularis mucosae without lymphatic metastasis. He has been at good condition for 7 months after the surgery. Curative treatment is essential for esophageal cancer even if it carries high surgical invasiveness, when the previous surgery for malignancy of the head and neck was curative. Thoracoscopic esophagectomy is useful to reduce surgical invasiveness for old patients.