Universidade Federal do Rio Grande do Norte, Natal, RN, Brasil.
J Bras Pneumol. 2009 Dec;35(12):1250-3. doi: 10.1590/s1806-37132009001200014.
Esophageal reconstruction is one of the most complex types of gastrointestinal surgery, principally when it is performed using minimally invasive techniques. The procedure is associated with various complications, such as anastomotic dehiscence, chylothorax, esophageal necrosis and fistulae. We report the case of a patient diagnosed with epidermoid carcinoma in the distal third of the esophagus. The patient was submitted to esophagectomy by video-assisted thoracoscopy and laparoscopy. During the operation, the left main bronchus was injured, and this required immediate surgical correction. In the postoperative period, the patient presented with acute respiratory failure and profuse air leak through the thoracic drains and through the cervical surgical wound. The patient underwent a second surgical procedure, during which a large lesion was discovered in the membranous wall of the trachea. The lesion was corrected with an intercostal muscle pedicle flap.
食管重建是最复杂的胃肠道手术之一，尤其是在使用微创技术时。该手术与各种并发症相关，如吻合口裂开、乳糜胸、食管坏死和瘘管。我们报告了一例诊断为食管下段鳞癌的患者。该患者接受了胸腔镜和腹腔镜辅助食管切除术。在手术过程中，左主支气管受伤，需要立即进行手术矫正。术后，患者出现急性呼吸衰竭，胸腔引流管和颈部手术切口大量漏气。患者进行了第二次手术，术中发现气管膜部有一个大的病变。病变通过肋间肌蒂皮瓣进行了纠正。
