[Combined resection of the thoracic aorta associated with subtotal esophagectomy for carcinoma of the esophagus].

With recent advances in surgical techniques and post-operative care, surgical treatment of esophageal cancer has been safely performed. Nevertheless, prognoses of such cases in which the cancer is invading the ajacent aorta and when only an incomplete resection was performed are very poor. The following case in which annular resection of the thoracic aorta combined with subtotal esophagectomy was performed and an aorto-aortic bypass graft was replaced was reported. A 70 year old man came to our hospital, complaining of difficulty in swallowing. The upper GI series showed a 8 cm long filling defect in the middle esophagus. Computed tomography suggested that the tumor was directly invading the aorta. The patient underwent two staged procedure operations. During the first operation, the left chest was opened, and a side-to-end bypass graft was replaced to detour around the tumor bearing aorta with 20 mm phi Dacron Double Velour graft. The aorta was then transected. The second operation was performed through the right thoracotomy. During the operation, the thoracic esophagus and the tumor bearing aorta were resected en bloc. The patient died of hepatic failure and right pyothorax 4 months after the first operation.