Membranous Tracheal Injury during Thoracoscopic Esophagectomy for Esophageal Cancer—A Case Report—

Abstract

We present a case of a membranous tracheal injury caused by a single-lumen tube during thoracoscopic esophagectomy, which was repaired by thoracoscopic direct suture. The patient was a 45-year-old woman. She was diagnosed with cancer of the middle to lower thoracic esophagus and underwent thoracoscopic esophagectomy in a prone position under differential lung ventilation, using a single-lumen tube and a bronchial blocker catheter. During surgery, we identified a membranous tracheal injury. While we asked an anesthesiologist to precede with tracheal intubation keeping sufficient respiratory management, the injury was directly sutured under thoracoscopy and covered with a polyglycol acid sheet and fibrin glue. On the 6th hospital day, we confirmed that the injury was closed by a bronchoscope and the tube was removed on the 8th hospital day. On the 12th hospital day, she underwent exploratory laparotomy under general anesthesia for acute abdomen which was done under respiratory management, and no noteworthy adverse events were noted in the air passage. We must keep in mind that a tracheal injury can be caused even by manipulation for intubation by using a single-lumen tube and that the repair can be possible with sufficient respiratory management by working in closer cooperation with the anesthesiology department.