Abstract
Salvage surgery after definitive chemoradiotherapy (dCRT) for esophageal cancer invading the tracheal membranous portion has a high risk of complications such as membranous tracheal perforation and necrosis. A 67-year-old man who had received dCRT for upper thoracic esophageal cancer invading the tracheal membranous portion achieved a clinical complete response.
Subsequently, local recurrence occurred in the primary tumor bed, and the patient received salvage surgery. Operative procedures included right trans-thoracic and abdominal subtotal esophagectomy, gastric tube reconstruction via retro-sternal route, and cervical esophagogastric anastomosis. We covered the tracheal membranous portion with a latissimus dorsi muscle flap to avoid the complications related to the tracheal membranous portion. No complications occurred, though esophagogastric anastomotic leakage was observed which was successfully treated conservatively. Salvage surgery for esophageal cancer invading the tracheal membranous portion carries a risk of causing membranous tracheal perforation and necrosis, and it often becomes fatal if it once occurs. We successfully prevented such complications by using a latissimus dorsi muscle flap. This operative procedure is easy and effective.
