Pectoralis Major Myocutaneous Flap Repair for Anastomotic Leakage after Esophageal Bypass Surgery

Abstract

A 66-year-old man underwent a medical examination for weight loss, dysphagia and dyspnea. He was diagnosed with unresectable esophageal cancer that had invaded the left main bronchus with para-aortic lymph node and multiple lung metastases. Esophageal bypass surgery using the Postlethwait procedure was performed because an esophago-bronchial fistula developed after chemotherapy. However, intractable anastomotic leakage via an ante-thoracic route occurred 14 days after the operation. Debridement, re-suture and pectoralis major myocutaneous flap repair were performed for this leakage. The postoperative course was uneventful and the patient has achieved long-term survival with improvement of his general condition and quality of life. This case shows the value of pectoralis major myocutaneous flap repair for anastomotic leakage after ante-thoracic esophageal bypass surgery.