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Kimura M, Nagasaki T, Kuwabara Y, et al. Eversion stripping of the esophagus with intraesophageal insufflation-A case report. Int J Surg Case Rep. 2017;36:86-89doi: 10.1016/j.ijscr.2017.05.013.
Kimura, M., Nagasaki, T., Kuwabara, Y., Tanaka, H., Hato, M., Taniwaki, S., Mitsui, A., Shibata, Y., Mizuno, K., Mori, Y., Ochi, N., Ueno, S., & Eguchi, Y. (2017). Eversion stripping of the esophagus with intraesophageal insufflation-A case report. International journal of surgery case reports, 3686-89. https://doi.org/10.1016/j.ijscr.2017.05.013
Kimura, Masahiro, et al. "Eversion stripping of the esophagus with intraesophageal insufflation-A case report." International journal of surgery case reports vol. 36 (2017): 86-89. doi: https://doi.org/10.1016/j.ijscr.2017.05.013
Kimura M, Nagasaki T, Kuwabara Y, Tanaka H, Hato M, Taniwaki S, Mitsui A, Shibata Y, Mizuno K, Mori Y, Ochi N, Ueno S, Eguchi Y. Eversion stripping of the esophagus with intraesophageal insufflation-A case report. Int J Surg Case Rep. 2017;36:86-89. doi: 10.1016/j.ijscr.2017.05.013. Epub 2017 May 15. PMID: 28550789; PMCID: PMC5447379.
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Int J Surg Case Rep. 2017;36:86-89. doi: 10.1016/j.ijscr.2017.05.013. Epub 2017 May 15.

Eversion stripping of the esophagus with intraesophageal insufflation-A case report.

International journal of surgery case reports

Masahiro Kimura, Takaya Nagasaki, Yoshiyuki Kuwabara, Hironori Tanaka, Motoki Hato, Satoshi Taniwaki, Akira Mitsui, Yasuyuki Shibata, Kotaro Mizuno, Yoichiro Mori, Nobuo Ochi, Shuhei Ueno, Yuki Eguchi

Affiliations

  1. Department of Surgery, Nagoya City East Medical Center, Japan. Electronic address: [email protected].
  2. Department of Surgery, Nagoya City East Medical Center, Japan.
  3. Department of Surgery, Nagoya City West Medical Center, Japan.

PMID: 28550789 PMCID: PMC5447379 DOI: 10.1016/j.ijscr.2017.05.013

Abstract

INTRODUCTION: Patients with esophageal cancer frequently cannot tolerate thoracotomy due to their overall debilitated condition. Moreover, some patients have severe adhesions in the thoracic cavity. Eversion stripping of the esophagus is an option for resection in these patients.

PRESENTATION OF CASE: A 64-year-old man was admitted to our institution with the chief complaint of epigastric pain. Endoscopic examination showed a protruding lesion 22cm from the incisors, with a superficial and circumferential mucosal irregularity on the distal side of the lesion. Biopsy revealed squamous cell carcinoma. Clinical stage was T1b(sm)N0M0, cStage I. In addition to the poor pulmonary status of the patient, adhesions in the intrathoracic cavity were predicted. The decision was made to perform esophageal resection without a thoracotomy. In order to ensure complete invagination of the esophagus, the esophagus was insufflated prior to stripping. The stripping process was observed with a gastroscope. During the stripping, the esophagus did not bunch up, and stripping was smooth and with minimal resistance.

DISCUSSION: The stripping resection of the esophagus is an important option for the esophageal surgeon. In this case report, we describe a new eversion stripping method of the esophagus. This easy and reliable stripping method incorporates intraesophageal insufflation.

CONCLUSION: The indications for blunt esophageal dissection without thoracotomy have been decreasing. On the other hand, our method seems to be useful in optimal case of stripping of esophagus.

Copyright © 2017 The Author(s). Published by Elsevier Ltd.. All rights reserved.

Keywords: Eversion stripping; Insufflation; Transhiatal esophagectomy

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