Pneumonectomy with Esophageal Resection and Reconstruction for Squamous Cell Carcinoma of the Lung as Salvage Surgery

Abstract

We describe a case of squamous cell carcinoma of the lung with invasion of the esophagus treated by radical en bloc resection as salvage surgery. Chest computed tomography showed a 46-mm tumor and a 25-mm subcarinal lymph node invading the esophagus. After three cycles of chemotherapy with cisplatin plus vinorelbine, the bronchoscopic findings revealed that the hemorrhagic tumor had progressed, and hemoptysis, cough and dysphagia were getting worse and proving very bothersome to the patient. To resolve his symptoms, we performed left pneumonectomy with esophageal resection and reconstruction. The esophagus was reconstructed via a posterior mediastinal route to use the greater omentum for coverage of the stump of the left main bronchus and the anastomosis of the reconstructed esophagus. Although he died of metastatic lung and brain tumors 18 months after the surgery, he was doing well more than one year after the operation. In addition, improvement of the respiratory and digestive symptoms was also achieved with complete resection.