2013 Volume 33 Issue 4 Pages 749-753
A 73-year-old man was admitted to the hospital because of dysphagia. Upper gastrointenstinal endoscopy showed a mass at the lower end of the thoracic esophagus, and endoscopic biopsy confirmed squamous cell carcinoma. Chest CT examination revealed lymph node metastases (cT2N1M0, cStage III). Because of respiratory dysfunction caused by chronic obstructive pulmonary disease (COPD), we considered that a radical esophagectomy may not be feasible, and selected chemoradiotherapy. After chemoradiotherapy, the esophageal tumor reduced significantly in size, although severe stenosis persisted. While the patient received endoscopic dilatation and palliative chemotherapy, he suffered from recurrent episodes of acute cholecystitis due to gallbladder stones. Therefore, both laparoscopy-assisted esophageal bypass operation for esophageal cancer and laparoscopic cholecystectomy were performed on the same day. The patient was managed to postoperative respiratory function disturbance by COPD and suffered minor leakage from the anastomosis; both disorders improved with conservative treatment, and the patient was discharged. After the operation, the patient was able to maintain oral intake without complications for 11 months, until he eventually died at 12 months.
