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KMID : 0364019760090020293
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Korean Journal of Thoracic and Cardiovascular Surgery
1976 Volume.9 No. 2 p.293 ~ p.297
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An Exclusive Right Thoracic Approach for Cancer of The Middle Third of the Esophagus
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Abstract
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One mid-esophageal carcinoma underwent esophagogastrectomy using an exclusive right thoracic approach entailing mobilization of the stomach through the esophagea1 hiatus.
62 year old male farmer was admitted with chief complaints of dysphagia and weight loss of 5 Kg. for 6 months, and regurgitation after soft meal for one week prior to this admission.
Preoperative esophagogram revealed stricture with fungating mass at the level of the Carina, which was diagnosed as squamous cell carcinoma at the time of esophagoscopic biopsy about 33 cm from incisor. Bronchoscopy revealed no invasive lesion or carinal fixation, and laboratory examinations were excellent for operative intervention.
An exclusive right thoracic appreach through right 5th rib bed was made for radical esophagectomy, mobilization of the stomach through the esophageal hiatus and primary esophagectomy.
Postoperative recovery was uneventful except increased bronchial secretion due to senile emphysema, and follow up for 5 months after esophagectomy revealed good functioning esophagus with mild epigastric fullness after meal.
Exclusive right thoracic approach for radical esophagectomy seems to be the procedure of choice in selected cases.
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