Stapled resection for bronchogenic cyst of the esophagus performed using video-assisted thoracic surgery

Abstract

Esophageal bronchogenic cyst is a rare congenital malformation. Although thoracoscopic resection is useful, it has not been adopted for esophageal cysts with a large size or severe inflammatory adhesions. We first reported a case of esophageal bronchogenic cyst that was completely resected using endo-staplers during videoassisted thoracoscopic surgery. A 28-year-old man was referred for the treatment of a mediastinal cystic tumor located between the trachea and esophagus. His chief complaints were coughing and chest pain. We performed the operation using a right thoracoscopic approach. The cyst showed an exophytic protrusion with a thin stalk connected to the esophageal wall. Because the split of the muscle layer around the cyst was difficult and the enucleation could not be performed, a partial resection of the esophagus using endo-staplers was selected. Histopathological findings were specific for a bronchogenic cyst of the esophagus. He has shown no signs of disease-recurrence or had any complaints.

Subdiaphragmatic bronchogenic cyst of the esophagus masquerading as a metastatic lymph node of coexisting advanced gastric cancer

“…Swanson et al [2] reported a case that had a fibrous stalk between the cyst and the abdominal esophageal wall. Similar to their report, we previously experienced a similar case in which a thin stalk was present between the esophageal bronchogenic cyst and the thoracic esophageal wall [12].…”

“…Whereas bronchogenic cysts are lined with pseudostratified ciliated columnar or cuboidal epithelia that sit on a smooth muscle layer and must contain cartilage or bronchial mucous glands, duplication cysts do not contain cartilage or respiratory glands and are lined with two smooth muscle layers [8,9]. Some previous reports have described the presence of elevated levels of tumor marker such as CA19-9 and CA125, and positive staining with a monoclonal antibody against CA19-9 in the esophageal bronchogenic cyst [10][11][12]. Our patient had neither positive immunohistochemical staining for CA19-9 nor an elevated serum CA19-9 level.…”

“…Esophageal bronchogenic cysts are usually small and less than 4 cm in size, and enucleation may be suitable for such small cysts [4]. As recently demonstrated, a laparoscopic or thoracoscopic approach has advantages for improving the postoperative course compared with open surgery, since such an approach can eliminate postoperative respiratory and wound-related complications [12,18]. In our case, the entire cyst was removed with the whole stomach and abdominal esophagus via an open transabdominal approach due to the need to resect the coexisting advanced gastric cancer.…”

Minimally invasive esophagectomy performed with the patient in a prone position: a systematic review

“…Over the last two decades, thoracoscopic surgery has attracted much attention as a less invasive approach for the treatment for benign and malignant diseases [13][14][15]. In 1992, Cuschieri et al [16] first reported performing thoracoscopic minimally invasive esophagectomy (MIE) for esophageal cancer, which sparked the interest of many surgeons because MIE has the potential to lower the morbidity associated with resection and to enable a quicker return to normal function.…”