ECMO-Assisted Esophagectomy after Left Pneumonectomy

Abstract

This technique may be an excellent option for the treatment of complex situations such as esophagectomy after pneumonectomy.

Transhiatal esophagectomy after previous right pneumonectomy

“…1 Furthermore, there are only 3 reported cases of esophagectomy being performed in a patient with previous pneumonectomy. [2][3][4] To date, this is the first published report of a transhiatal esophagectomy after previous right pneumonectomy. Repeated entry into the thoracic cavity in a patient who has undergone pneumonectomy presents several challenges as a result of postoperative compensatory anatomic and physiologic changes.…”

Mediastinoscopic salvage esophagectomy for recurrent esophageal squamous cell carcinoma after definitive chemoradiotherapy in a previously pneumonectomized patient

“…Reardon et al reported right transthoracic esophagectomy after right pneumonectomy, but they found it challenging to operate in the postpneumonectomy space because the pericardium, great vessels, and/or esophagus adhered to the lateral wall . To avoid thoracotomy in the postpneumonectomy space, right transthoracic and right thoracoscopic esophagectomy after left pneumonectomy have been reported . However, in both procedures, the contra‐pneumonectomy–sided transthoracic approach forces the remaining ventilated lung to be retracted, which requires pulmonary supports such as percutaneous cardiopulmonary support, extracorporeal membrane oxygenation, or differential pulmonary lobar ventilation using an endobronchial blocker tube .…”

“…To avoid thoracotomy in the postpneumonectomy space, right transthoracic and right thoracoscopic esophagectomy after left pneumonectomy have been reported . However, in both procedures, the contra‐pneumonectomy–sided transthoracic approach forces the remaining ventilated lung to be retracted, which requires pulmonary supports such as percutaneous cardiopulmonary support, extracorporeal membrane oxygenation, or differential pulmonary lobar ventilation using an endobronchial blocker tube . Velotta et al reported mediastinoscopic transhiatal esophagectomy for a patient who had previously undergone right pneumonectomy .…”

Postpneumonectomy transthoracic Esophagectomy – a case report: using anatomic change to create Extrathoracic Esophagogastric anastomosis

“…Esophagectomy in the setting of prior pneumonectomy is challenging and only few cases have been reported to date [ 1 – 5 ]. A dilemma remains regarding the approaching side, as pneumonectomy has left substantial deformity in the ipsilateral thoracic space, whereas operating on the healthy side puts the residual lung at stake.…”