In 22 patients with esophageal cancer, mediastinal lymphnode dissection procedure, with preservation of the right bronchial artery and pulmonary branches of the right vagus nerve, was performed during radical esophagectomy. In patients who underwent this procedure, respiratory function was sufficiently maintained against severe complications and the operative and hospital death rate was less than that of other esophagectomized patients.

A giant leiomyoma of the esophagus, 11.5 X 5.0 cm in size, which occupied half of the esophageal circumference, was surgically enucleated. A small epithelial defect caused by the enucleation of the tumor was directly closed, and a large muscular defect was covered with a latissimus dorsi muscle flap, introduced into the thoracic cavity through the space where the second rib had been resected. Postoperatively, a leakage at the epithelial suture line was noted, however, it was localized by the muscle flap coverage and spontaneously healed two weeks postoperatively. During the follow-up period of 1.5 years, no diverticle formation or stenosis occurred, and the patient had no complaints. The present clinical experience indicates that this procedure may be a useful method of grafting after excision of giant leiomyoma of the esophagus.

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A 72-year-old woman was carried in our hospital with the chief complaints of abdominal distention and vomiting. The patient was diagnosed as occlusive ileus due to a rectal cancer and temporally double barrelled colostomy with sigmoid colon was performed. After that, although the patient had sufficient evacuation, a progressing abdominal distention was found. Abdominal CT revealed a locally enlarged digestive tract at a location where the lower abdominal distention was seen. The patient was diagnosed as having localized ileus developed anal-side from the preternatural anus, and radical operation was performed. These ileus episodes were clarified to be caused by advanced cancers existing at the sigmoid colon and upper rectum (synchronous multiple cancer). Preoperative examination often fails to offer full informations about multiple cancer, especially for patients undergone emergency operation due to colon cancer-caused ileus or perforation or those presented with severe occlusion due to anal-side colon cancer. We should remember a possible existence of multiple cancer in the treatment of colon cancer in all cases.