Abstract
Cardiovascular disease is a risk factor of causing perioperative complications in performing esophagectomy for esophageal cancer, and the usefulness of β-blocker to prevent such complications has been reported. This time we present three patients operated on for esophageal cancer associated with severe cardiovascular disease who could be dealt with careful perioperative management. Case 1 involved a 79-year-old man who had LtcT3N1M0 esophageal cancer associated with triple-vessel disease. Following neoadjuvant chemotherapy, we performed esophagectomy with reconstruction by laparotomy-right thoracotomy approach, and managed him by administering percutaneous β-blocker during perioperative period. Case 2 involved a 73-year-old man who had Ut cT1bN1M0 esophageal cancer with non-ischemic cardiomyopathy (EF 32%). He was operated on by two stage operation, in whomβ-blocker was administered orally before surgery and via percutaneous route after surgery. Case 3 involved a 65-year-old man who had Lt cT3N1M1 (LN104R) esophageal cancer with stenosis of the left main coronary trunk. The case was of remnant cancer after radical chemoradiotherapy. We performed salvage operation (esophagectomy by laparotomy-right thoracotomy approach) and managed by administering β-blocker orally before surgery and via percutaneous route after surgery. In conclusion, all patients who had esophageal cancer with severe cardiovascular disease could be successfully managed during perioperative period by cooperating with other departments and by using oral and/or percutaneous β-blocker.
